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Form 112 MIII III.$ i ,.,.Ws. tabors.•, 87-- 104240 w..�..•. e� .. w pwoaer Notice is hereby given that - Ngrt,hwest.e.ra hu0.I c;_ .5er.vA.Ge. _Qamp.a.nY---- ...- ....... intends to claim and hold a lien in the amount ofjorty-- one-,hundred _twenty - eight -_ &- no /do7liera (: 4128.00. ----- _), with interest thereon from the ._ _LP t. h.. ....... day of 4u-ne........... 19. $.Z., at the rate of per cent per annum. That such amount is due and owing to the claimant for (labor performed, or for skills, services, material or machinery furnished)* for the following im- provement for which the same was done or supplied, to -wit .in_sta_ll_ed new - 32.6B0380.55___ -___ Bryant furnace plus a nPw 5,67G024.Bryant- air -_ cone_ i_ doner_,•.wi_th ------------------ thermostat The name and postof f ice address of the claimant is . __ N p r t - -h w e s te r n----------- l e ___ � ----------------------------- __ Com�an +n P, o. Box 2Z0 Grand ... Island._N-ebraska ____68802_ - 0220_-------------- _ The name and postoffice address of the person for whom the work was performed or materials furnished is _."1ike_GraY_�.._9.60-- 5a_ -- --- . Oak,--- G-"- aD- d--- i_ sl_ aSld-+--- Ii_ eh. t_ 1S. iS .1-.-- -- -------- ---- ------- - - -• i The date when the first item of the claimant's contribution was made was the ---------- day Of __.____ J une._ ------ - ------ _--- ---- ,., 19.07.., and the last item of the claimant's contribution was made on the - ?4th_ __ day of -July - -, 19_ 87. The following is the description of the property to be charged with the lien, to-wit: ------- --------- ------ South 10 feet of Lot. 87 and Lot 86 of Hawthorne Place A --------- - - -- -• ---- - - all 09 ----------- ------------ -- - The name and address of the owner thereof at the time of making such statement according to the best information that claimant has is . Mike...Q. ray,-- 9fi_ Q__ S. o. u_ tkt .,_._.__ -.•.- Nebraska _ ._.. - - -- - -- - -- - - - - -- ------ - ----- Following is an itemized statement of the account upon which the lien is claimed: _____ .• -------- __.._ '= - .376B036055 Bryant furnace plus 567G024 Bryant. air conditioner with - -------- thermostat. - _ - - -. -- -- - -- -- -- - --- -- - Aated this -- _ day of _ _ _ - _. __. __.. c "Strike bet w not appleat�. Lien Claimant. STATE OF� County ,fJ being first duly sworn say that - he is . _ ._1 1 fh 4s±%ttt !/- ..i1�S%Y��'f-\ t- -- - - - - -- -- fh - the. lien claimant mentioned in flee fo going statement; that he has read said statement and knows the contents thereof; that he has knowledge of all the facts therein stated, and that said statement in in all respects true. 4. 7 - � - - - - - . Subscribed and swgrA -ftAf t Kis . - _. f _4 -_ -- -- day of � _-.. - --- ., 19 Y 111 419 90. J, - --- ---- - - -- -- _ - -- - (Name of office) STATE OF County of ......... -- -- _- -- -- - - On this ...._ __ _... day of . _- _ - --. . , 19 - before me personally appeared __. _ .4. _ ..._- Safi,. _ known to me (proved to me on _ ) to be the described in and .. executed the within and foregoing instrument, and acknowledged to me that executed the same. (Name (of office)