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<br />lLJ <br /> <br />II 'T~._ <br /> <br />.-J^~~~~- CON~!~UC-"T.!Q~_ ~'!O~______ <br /> <br />-~ <br /> <br />____.___ Jacob North Printing Co., .I.!!.C., LlncolnL NE 6852~ + <br /> <br />J <br />o ~I <br />.~ 01 <br />(::) ~I <br />CD z <br />o iJ <br />N C <br />-oJ :::: <br />N~ <br />_ LO~l'L <br /> <br />I <br /> <br />n~ <br />ificn <br />OX <br />'" <br /> <br />~~~ <br />t\ ~ \?O. <br />~~~ <br />p;. ........ <br />""":: --'"'\ \\" <br />,S;;;. '> <br />0> " l.J'-. <br />'-\. h' <br />...., ---- <br />~ l-.::;. ,..:;>--.~ <br />~). ~ ~, <br />tr--- ~ a--- <br />7'<<. p:,. <br />~ ,~ --::J <br />........ v:. <br />^-...." 'V <br />c;, ~. <br />~ <br /> <br />1ItJ <br />m <br />2! <br />(") z <br />~E~ <br />Q:c <br /> <br />,--=- <br />~ <br />c:.::::> <br />ex;> <br /> <br />C>(/) <br />b-l <br />C:'~ <br />::z-l <br />-\,.., <br />-<0 <br />0"" <br />""z <br />:J: P1 <br />:p-CP <br />.::0 <br />c-> <br />(f) <br />;;>0: <br />> <br />~"~ <br /> <br />~l" :D <br />~.' ~~ ;g <br />0, ~ <br />o ...... <br /> <br />i. t\l' \J <br />1'1" ;:3, <br />I::' <br />ffl c...J <br />,..... <br />-.J <br />CONSTRUCTION UEN 2008027 29 <br /> <br />~,w <br /> <br />1. The real estate subject to this lien is: LoT 110 B loe-k .J /~I vcrs d e A c: ~t'S <br /> <br />f\ d cL'+ \(; (--) ) H 0-\ \ (' (\t1.r\'\~ J \J E <br /> <br />.}\ <br /> <br />N <br />S <br />s- <br />o:> <br />S <br />N <br />-.j <br />N <br />to <br /> <br />QIl'l <br />ws <br /> <br />~:r--"", <br /> <br />.~- .--.~..-;~.;'~..;..:. <br /> <br />,... '.- <br /> <br />Ii <br />,I <br /> <br />; I <br />I <br />i <br />, <br /> <br />2. The person against whose interest in the real estate the lien is claimed is: <br />S~n-.'Y\rl W€\I&j J)eY\O~f:..L tlhdJa.cK !J,W~Se- <br />3. The name and address of the claimant is: _~ rf'\\f'_ .s;;. <:... h 0-.- b e r\ 3 rr d. ~. Fo \' t- <br />Crce\<'.. Stu"ln BeIlF\ILle... ~E 1.o~1d..3 <br />I <br /> <br /> <br />i <br />i <br />I, <br /> <br />II <br />II <br /> <br />I <br />! I <br />_IL___ <br />T1 <br />Ii <br />II <br /> <br />4. The name and address of the person with whom the claimant contracted is: <br />k'Je{'qcle.. <br /> <br />bYYOj <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: <br /> <br />re\Qcf The hO\1 S e \J.JITh WC;(rl ,c; ho.-kt's <br /> <br />: 6'jComplete one of the following) _ _ _ <br />_ The amount unpaid, whether due or not, to the claimant for the services or materials is $ ,3/) '75 b ( 00 <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 />J The time the last services or materials were furnished was -J a-n u ()... <' j 3 0 } ~ GO <g <br />_ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br />I <br />II <br />Ii <br /> <br />A~Jl-1(~JtJ~ <br /> <br />Signature of Claimant' <br /> <br />,~~. <br /> <br /><-~ rJ day of h'\ARC.H <br /> <br />,~u.&<> ,71 /1) Qf-'l <br />Nota Public <br /> <br />Ii <br />! I <br />I <br /> <br />Subscribed and swom to before me this <br />bj Bcr (lOcnl cr. Sc ).,o,.1en <br /> <br />~~. f>L- E~,f -) - S -2\ 0\ \ <br /> <br />i <br />; (52-147. See 52-148 for amendment; 52.149 for assignment; 52.137 for recording time; 52.154 for discharge or release). <br />i <br /> <br />i <br />II <br />i i <br />II <br />II <br />Ii <br />II <br />II <br />II <br />; !! <br />__""___..--===-~:=-.t~ <br />Rev. 9/9~ ! I <br /> <br /> <br />GeNERAL N01MY .... II NebrIska <br />UNO" A. tAPE <br />MvComm, Exp. ~Iy 18, 2011 <br /> <br />I <br /> <br />I <br />I <br /> <br />R~,n t-C', <br />~ef' ,..:. e~ c\, 0.1<" '""", <br />:31 C),L\. t-tJct C:(CG~ 50.....t1-.", <br />6c:\\evu.e I iDE (06)18. 3 <br />i i -~- <br />