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<br />tII$TRUCTION LIEN <br /> <br />Jacob North Prlntln Co., Inc. Lincoln NE 68524 <br /> <br />f\.) <br />G <br />G <br />Q:j <br />G <br />G <br />-...,J <br />OJ <br />W <br /> <br />~ <br />~ <br />~ <br />t ~ .s::' <br /><::. i::J <br />f.-) X ~Cn "- <br />Vi ~. <br />r' (t>.. . <<; <br />.~~.()Z <br />~.C\j~~ <br />\jJ C7::::i <br />~ l -- ~ <br />rtr ~~ <br />~ ~t <br />~. ~ <br />~ ~ <br />t ~ <br /> <br />1. The real estate subject to this lien is: <br /> <br />314 South Vine St. - Grand Island. NE <br /> <br />~--. <br />!\. V <br />=t:;10 <br /> <br />~f~~: <br />~~~-.,. <br /> <br />~t <br />n::t <br />~ <br /> <br />~ <br />"TI <br />c: <br />Z <br />~~~ <br />n .(1) <br />,..:::c <br /> <br /> <br />'~:( <br />~.1] ~..\ <br />;~:; < "'.'. <br />(.:J ~,{~ <br />.,., <br />v' C~ <br />;~~ i\ <br />C::-J C <br />(ll ~, <br />~ <br /> <br />::n <br />::3 <br />!---> <br />C) <br />.....r.: <br />0) <br /> <br />'1 <br />;-r. <br />co <br /> <br />!---> <br /> <br />200800783 <br />CONSTRUCTION LIEN <br /> <br />C) uo <br />o -1 <br />C"..: 1:>- <br />z -. <br />-j Pl <br />--< c::> <br />C) -,-, <br />'1 :;;': <br />_.~ n I <br />:r:,.... ;;,,';:"J <br />~1:J <br />,p. <br />0) <br />X <br />1> <br /> <br />.......--.... <br /> <br />(j') <br />en <br /> <br />68801 <br /> <br /> <br />Hall County(Lot Three (3) Block Seven (7) Koehler Place in the City of Grand Island, <br />Hall County, Nebraska / 200607452) <br />2. The person against whose interest in the real estate the lien is claimed is: ...: - l' . -.- '::s <br /> <br />l-etP/22LJ 01-t-i/ ~kl'" A~/-)q~""5 <br /> <br />3. The name and address of the claimant is: ---.-SQ.1,!kup I s Heating & Air Conditioning. rnc. <br /> <br />P.O. Box 5432, Grand Island, NE 68802 <br /> <br />4. The name and address of the person with whom the claimant contracted is: . <br />-;i).7R ~ "l.! T~_ r'P'~_.J Llm. HFl C64iQ-S Je~ 41/v!/21A~/> 10,tC-.Lq.......5 <br /> <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: HVAC contract work performed in <br /> <br />home address listed above (#1) <br /> <br />6. (Complete one of the following) <br /> <br />-XXX- The amount unpaid, whether due or not, to the claimant for the services or materials is $ 499.49 <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 />-XXX- The time the last services or materials were furnished was June 19, 2007 <br /> <br />- The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br />Subscribed and sworn to before me this <br /> <br />c:;d L ~~ ,oLJ-ow~-yJ <br /> <br />Signature of Claimant (Sec. of Corp.) <br />~~l1.t;,t/-S t/A/"1j> pi 4/C <br />'"/ U '1-- ~ <br />-~ <br /> <br /> <br />I J;GENERAL NOTARY - state of Nebraska <br />BRYAN J. SIMONSON <br />. My Comm. Exp. Feb. 13, 2011 <br /> <br />---- ~., <br />o! t.i;) ?5", <br /> <br />arge or release). <br />