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<br />N <br />S <br />S <br />0) <br />S <br />(0 <br />N <br />-....J <br />-....J <br /> <br />" "" I 11,.,_.._ <br />~-_.- <br />_Jacob North Printing Co.. Inc., Lincoln, NE 685;~:_.tt <br /> <br />II <br />II <br /> <br />N$TRUCTION LIEN <br /> <br />09J~ <br /> <br />r 0-. <br /> <br />~, .-J:::: <br />o - <br />Q ~3 <br />/ ~ <br />?~(\\ <br />CbJ d' <br />(), V' <br />~~~ <br />6 <br /> <br />;lIa <br />m <br />." <br />c: <br />t'l Z <br />.:I: nO <br />m>$!l <br />nc.n <br />1'Iii;::J: <br /> <br />nn <br />::J:> <br />m (I) <br />n::J: <br />;li; <br /> <br /> ,r "",,) <br /> ,,::,:.;:_;:~ CJ (Ii <br /> r.:::~:;;;) <br /> '-~ 0 --I <br /> ('".::J c: >- <br /> z -. <br />,,,..,..~ -::-? ~ iii <br />rrl ---l <br />~) -< c:' <br />(;) I---l 0 "'I <br />.." co -'1 <br />"'l.! <br />r' '~, I ""~'. ':.1": I /'1 <br />r~"1 ;,'~' \ ::n }..:-o C,':.) <br />r~q ., :.:3 ;~) <br />l:,::) ~ (- J,:':'" <br />(.() t. I---l rf") <br /> t- I---l 7; <br /> };::10- <br /> CJ ---- ---- <br /> ....c C/) <br /> (j) <br /> <br />"" <br />o <br />o <br /> <br />200609277 <br />CONSTRUCTION UEN <br /> <br /> <br />I <br />I <br />~~II <br />I <br /> <br />1. The real estate subject to this lien is: 7 he So q LA ('!)rJ~ ;/al f c:> ~ l.o 1-..:5 (j) <br />a /lAG) ,!J,(! k TA reel3) F/rsf tlJ-dd,'"t-I):, J1 tJJ ftltJtJj /i1;;('r //4'11 <br /> <br />2. The person against whose interest in the real estate the lien is claimed is: <br />$f.p/).1"n /v1, FcPs-tpr <br />I \ Ai II ~ C ..:. <br />3. The name and address of the claimant is: ..JLJ/) ( /I d /J'J E r oc;7?r , <br />Gib6i#4) }/EbES6J!O . / <br /> <br />4. The name and address of the person with whom the claimant contracted is: 5kt:>);p h /JI <br /> <br />/';>0'('<; lyS-t t#~J 11;;lf')- )0/ E G t'6'f>:3 / <br /> <br />d cJ? ~ !sPy ~ P'C-I I <br />I <br />~5j;pr- <br /> <br />5. A general description of the claimant's services performed ~ to blUJftrformed qr materials furnished or to be <br />furnished for the improvement and rntract price is: Lt!!.. A~ Ct Ll" / ~ I') L d ~ <br />J" t!?rJ1 Ii/cd hp ,ser1'q ()()o and jqbor (NI tfd/; ~/8J1 <br />) 0 CJt!Jo. <br /> <br />6. (Complete one of the following) <br />~ The amount unpaid, whether due or not, to the claimant for the services or materials is $ ~ t!JttJO <br />~ The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br /> <br />7. (Complete one of the following) <br /> <br />/lJ,/(1 A <br /> <br />;;tPtfJO <br /> <br />~ The time the last services or materials were furnished was <br /> <br />~ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br />9I'~1! ~ <br /> <br />Signature of Claimant <br /> <br /> <br />day of cO~ zf-~ , <br /> <br />~~L'- - JR.... f.:>p." <." " <br />Notary Public <br /> <br />/ t3de- <br /> <br />Subscribed and sworn to before me this <br /> <br />./ <br /> <br />6ENEAAl NOTARY - staf8 of Nebraaa <br />DENICE R. KRuse <br />My Comm. &po 25, 2010 <br />(52-147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52-154 for discharge or release). <br /> <br />I " <br />j i <br />; i <br />~!i <br />: i <br />-.-------=--=:::::::~:~~:.::::::::.::::: :::- _.: :tt::::.: <br />_ _____ ~ev. 9/9~Lll <br /> <br />l <br />! i <br />: ) <br />I' <br />II <br />! I <br />; i <br />, ! <br />: i <br />: I <br />