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87-104969 <br />fluffman and Felton 6 Wait, Welton, ftc OWI <br />CONTRACTING OWNER OR SUCCESSOR IN <br />INTEREST. <br />M. 4X.1_. U. - ok-, <br />(Name) <br />CLAIMANT: <br />(Name) <br />(Address) &M3 <br />(Phone) <br />REAL ESTATE; <br />_L T ....... 7 ........................ <br />(Legal Description) <br />----- I ............ _ .......... ­ ................................ .......... <br />44itti. ....... ............................... <br />CLAIMANT CONTRACTED WITH: <br />Itiv.A . ................. ...... ............... <br />(Name) <br />(Address) . 3.(a.. . .... Ptv ............ <br />ft`r� .... OW <br />............... ........... <br />(Phone) <br />SERVICES OR MATERIALS FURNISHED BY CLAIMANT: <br />...... I .......... ............... <br />CONTRACT PRICE: S. AMOUNT UNPAID: <br />TIME LAST SERVICES OR MATERIALS FURNISHED: 81.0-18 7 .... . . ... . ...... .................... <br />State of _ , N.t.12'r, <br />_ ­ . HcO I . Countyl Signature of Claimant <br />On this � � ,.?0- . . day of AA�Llt.� 19 je /, before me a Notary Public in and for <br />said county, personally came Z)"&_VLlL, P. VILVISAUJ ....tome known to bethe identical person or <br />persons who executed the foregoing release, and acknowledged the same to be his, her, or their voluntary act and <br />deed. <br />County, the day and year last above written. <br />Zt Public. <br />My commission expires the........ .._.day of.. S,2 <br />STATE OF <br />Entered on numerical index and filed for record <br />County of ......... in the Register of Deeds Office of said County the <br />..............day of 19 at... _.....o'clock and... ........ .... .... minutes... .......... M., <br />and recorded in Book of _ _ __..at page.- . . . <br />. I ­ ..___.___..._............_ ..._....__.........._._..._Reg. ­ of Deeds <br />By..........__- . -_.__ .._...._._ ........... ..... . ......... .... . .. Deputy <br />