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<br />J I' <br />II <br />---_..._._._....::::=::::~==:=.- ._~ <br />j I <br />____.______~_..__.___ _._______ Jacob North Printing Co.. Inc., Llncol'!... NE 6~_ -H--- <br /> <br />I <br /> <br />~STRUCTION LIEN <br /> <br />N <br />S <br />S <br />-...J <br />is <br /><0 <br /><0 <br />0) <br />(Xl <br /> <br /> 10 n ~ <br /> m :J:: .~.~.:J <br /> .." m en <L~'.~.,,) 0 0') <br /> c: c.:::;.-::> <br /> Z n ::t '-",1 --.::I 0 -j <br /> ,... C 1,. <br />~ C ;-,...JI,:"_. -...,... """'="'~ <br /> ~:,-~ -". <br /> ....... <br />~ ,......,J ~-=,:J -i r" <br /> r-n c:::= -< <br />CI) (.;') c::::. <br />:J: rv 0 -''') <br /> c.-:::: 0) .'j"l <br /> -""'f:1 .., <br /> ,':'.'-' J"':" <br /> 1"'" U t~~ C' <br /> -\ .. <br /> !,~~ ;n <br /> 0 ("i"1 ~ ::3 . <br /> (~) r ~.-.... <br /> (,f) (> (fl <br /> ~ W X <br /> po <br /> N ___ 0.,-- <br /> CD (t) <br /> fIJ) <br /> <br />~~ <br />r:'\ 01.1- <br />'Jj~ ~ <br />~ ~ ~, <br />~~ <br />--~tN <br />H:n~ <br />v- (\ <br />_. 0- 7\ <br />D IT~' <br />~*~ <br /> <br />, "T'C'. <br />c::. f\..J ;;r. <br />r\ <:t.. ;-. <br />c.... <br />"'. <br />~ <br />"I, <br />"'\ <br />~ <br />~ <br />S <br />". <br />It <br />1. The real estate subject to this lien is: <br /> <br />n <br />:r: <br />m <br />n <br />~ <br /> <br />\}. <br />~ <br />""c <br />10 <br />iN <br /> <br />CONSTRUCTION LIEN <br /> <br />200709968 <br /> <br />5:5; <br />tI ]nl"1ALJ-e..J I J L()+tgS-l;)eJth~lf"" <br /> <br />/5()g <br />. <br /> <br />2. The person against whose interest in the real estate the lien is claimed is: <br />~ _ ,r) <br />U n W\!.s () '1 ~ 9:..( t, , ,,..e 1"(, <br /> <br /> <br />3. The name and address of the claimant is: <br />r'Y~q~ (0. Ptbb)'++1< {J (l.,I <br /> <br />ods <br />Ie; () 'I 1\) . lStJe'lA W.j> 1\ tFt ~L C, I ~)C L"lX"fj03 <br />r . <br /> <br />f'n\\.u. ~''\\{)1. - ''''\~J/J 1:Y\{.~tv~ -+ ~'~rc.1 <br />\\Jr." G~~o3 <br /> <br />4. The name and address of the person with whom the claimant contracted is: ;}\~c.. \~\ v-k'V(^-. <br />/6C:'{--6 N b{ D6i:() tull\ i~ \JJ.. C.:., I \'J L- to '6"6t'>j <br /> <br />I <br /> <br />II j <br />I I <br />I I <br /> <br />5. A general description of the claimant's services performed to, to be performed or materials furnished or to be <br />furnished for the improvement and the contract price is: <br /> <br />-T""". -<:,J-,l )e'r{i f)oQll.J--' SeW€y -trJ ~D(..-\S-E: .Cr()fY'\. (<)-vI "'::.<2.~rnc;..;_: ""' <br />~ .. <br /> <br />CA. \ \ etA (-;Joo () ..~ <br />, <br />6. (Complete one of the following) <br /> <br />----.l The amount unpaid, whether due or not, to the claimant for the services or materials is $ 6)000 :'~ <br /> <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 />~ The time the last services or materials were furnished was .J ,..J1:- I <br /> <br />~y ()1 <br /> <br />~ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br />I <br />I! <br /> <br />~~C\.u..."t- ~~C ~y~.{ <br />'_5v..- <br />Sign~!ure of ClaimAAlt. 'I <br />....); \'f'\\'K~ ~, <'-i <br />2,--i-h 1\. If <br />. \.LJ \. day of ~ \J DU f' rv...J.Jt' ~ ' Zoo 7. <br /> <br />Nt:;~~~bt~/\ ~ . -~/tt------1 <br /> <br /> <br />Subscribed and sworn to before me this <br /> <br /> <br />hi GENERAL NOTARY" State of r~ebraska <br />I~ KARMIN MAUL <br />;. M Comm. Ex . June 24 2008 <br /> <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 />I I <br /> <br /> <br />I <br /> <br />! <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I ! <br />1 <br />I <br />I <br /> <br />" <br />Rev. 9/9_ ! i <br />