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Form 1 ? '2 .4 cuim f.. 86— 100787 Kaftri.lwaa's Notice is hereby given that N rert �,,Wwl,s'. -C-r I-.; p any ------- ... ........ unt of V 10_� 11, nandrv--d 'dollars intends to claim and hold a lien in the an"i 5 4 7 1 ..7.13. from the _. ). with Interest thereon day of v c- m e-!' 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 neliv and install new provement for which the same was done or supplied, to-wit -------- --------- ------------------ ft- -new #246B - SW Brant -- - ------ - --- ------ --------------- --------------- ---------------------- ------- - ---------- ___, n -------------- 1 � ---------- -------- - -- ------ ------ -- ------ ------------ ---- _ --------------- ---- ------ --- ------ -------- _ ----- -- 1. _ ---- - -- -- -- --- --------------------- -------------------- -- --------- ------------ ! c Sery ice _.C.0�_. The name and postoffice address of the claimant is --- N OrAh!!-�! ------- ; ------------- P. 0. Box 220. Ora d..'sland, Ne- b -ra -s -k -a --- ------------ --------- - - I ------ I ------- . ....... _n I - - -------------- ----- -- -- - --- - ---------------------------- The name and postoffice address of the person for whom the work was performed or materials furnished -s Patton En",.erprises inc., Broke.rs. LOL)nge,_3235 ---- S-0-u-t-h- ------------ day Grand I d t 11 when 6�6 a ... Ird N. , , 63807, The date w item of the clamant's contribution was made was the of Oc tob.e,r claimant's contribution was made on the and the last item of the claima. ------ h day of r 19 The following is the description of the property to be charged with the lien, to-wit -------------------------- Feereverse sid e . --------- -- --- --------- ------------------ ___ ------------ - --- - ---------- --- - --------- - --- - ---------- ---- 1 --- - -------------- � __J ------- - - ----- - - --- ------------------------ ------ - ------------ - --------- ---- -------------------- --------------------------------- - ------- The name and address of the owner thereof at the time of making such statement according to the R - r t e. r f-_i _ae -,_, __. - - -- ---- best information that claimant has is --- ---- In.- s Srand T n ------ I ------------ ----- - Following is an itemized statement of the account upon which the lien is claimed: ----------------------- 4.n w 8-W --- Br-y-a r�,, -- - - ---- ----------- ----- ---- - --- ---------- ------- - -------------- - --- --- - -- ---- -- ----- Dated this day of 'i B 1 C. --- ------ - ------ - - N I'� R 7 HW E S F R 1 5 Y i c: h 1 e. Lien Claimant. *Strike out words not applicable. STATE OF N E B F A County of 1, a r being first duly sworn, say that he is r r 7, n s u e r- e_: V es __.____ the lien claimant mentioned in the foregoing I statement: - - - that ---I- - -- he h . as read said statement and knows the contents thereof; that he has knowledge of all the facts therein stated, and that said statement is in all respects true. O NRTHWESTERN E B Y Subscribed and sworn to before me thq'�q of mh STATEOF County of before me on this day of personally appeared L % r r Y r knottlin to mt (proved to me on oath of to be the described in and exerut(d the within and foregoing inst"iment, and acknowledged to me that ,-,-rvt(d the same. f "W. rai° i? �f�I1�31iI3f# lilt! RlRiltt� #[Et�ilE414itk1it�t�ir£M� _�