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<br />G~~cJ .,l~dac-~ Nc- <br /> <br />)...01 2 of GVthlC' .s1a..~1.ci <br /> <br /> <br />2. The person against whose interest in the real estate the lien is claimed is: JJaw 8lJ<J.t'C1 ~ lie IOJ~'-1. <br /> <br />~Uc31lt.c> lklt41es/ ~l'eYeiA1Y No,t'C.) 12a..\e l/OJ1hiJ/>eVl , <br /> <br />a. The name and address of~he claimant is: LJi.t.tev L-.)()V'k.~ PJLJ"ub"tA~ (()~1jy.4(:tz,n t.l.L <br /> <br />PD, (J,t)^5q42. 6.V'tu....d ..r-.s)avld N~ IOg~O?_ <br /> <br /> <br />4. The name and address of the person with whom the claimant contracted is: ~ij IlL.) fI.e lIMe <( <br /> <br />:I'e>l'elM7 ^[(L~ - VLLvlfJutlr"l:l DeveJcj>t11~,,1. f F?o. fu 5S2-2 b I'kl.v<J ~ id"cJ, <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 />P\l.?\A-t b ~" ~ ti, V' AJe w..U Hov.. e <br /> <br />N <br />IS <br />IS <br />co <br />IS <br />..j::::.. <br />co <br />N <br />IS <br /> <br />'...._- '~-~'- ~' - <br />, , <br /> <br />i <br />i <br />I.. <br />1 t <br /> <br />: \ <br /> <br />1. <br /> <br />~NSTRUCTION LIEN <br /> <br /> Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />.,~.~~._---- ""'.'-~-~~~"~------~'~~----~--~~'-' <br /> 10 j-"'" aifJ d ~. <br /> n E .,.:..:> <br /> m <==> o~ <br /> :r c:c N <br /> "" ~ c:J> <br /> c: m c- %-1 <br />n Z n :r c::= -1m 0 :0 <br />~ 0 '" ~~ :z: -<0 0 m <br />:E: rn C <br />rn ~ 0.. - 0"" > <br />0 en <:) ..J: "z co en <br />~ :c ~ t ::ern z <br /> c:> l>(XI <br /> """ m -0 ,:::0 ~ <br /> fT1 ::3 rJ> <br /> 0 (/l <br /> (J cP ....... :;:><: c <br /> :po s:: <br /> ---- m <br /> r-.:J z <br /> en '(I) -t <br /> GA <br />CONSTRUCTION UEN 200804820 < So <br /> ...., ' <br /> <br />--,.. ..._._-----~---- -...--.------'" <br /> <br /> <br />it' <br />... <br />~ <br />7:; <br />~ <br />s:: <br />:5 <br />C)- <br />5- <br />U <br />~ <br />~ <br />~ <br /> <br />...., <br /> <br />l"- <br />I"'-' <br />~ <br /> <br /> <br />6. (Complete one of the following) <br />A The amount unpaid, whether duj. or)f,t, to ~~;r~t >>~etrs or materials is $ 'IZ2:J. 95'-:- <br />.~- The unpaid amount is not fixed by the contraet, but a good faith estimate in the amount of $ <br /> <br />7. (Complete one of the following) <br />~ The time the last services or materials were furnished was to - 3.- 0 f3 <br /> <br />-- r';:-he time the last services or materials were furnished has not yet OCCUlTed but is estimated to occur <br /> <br /> <br />L Lc.. <br /> <br />- <br /> <br />Subscribed and sworn to before me this <br /> <br />\'\ \~-\\~ .,,\~ day of ~\\l\Q <br />\~ ~ ~\~ <br />Notary Public ~ <br /> <br />,\~. <br /> <br />(52-147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52-154 for discharge or release). <br /> <br /> <br />i' <br />I" <br /> <br />flEQGy L. FIle <br />~ Notarv <br />SteM or NeblOIIlO <br />_~.E"'Ma30.2011 <br /> <br />-"-'-'--.'.(--~:'-'--""._'~='~~~-~--.--"--~"'._.'. <br /> <br />Rev. 9/9 <br /> <br />~"- "'-'I~~----';--~'_..__'."~__'~~~._~'_'__'.._'._._'__' _'''.''~ . .'n <br /> <br />: j <br />