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<br />~ <br />~ <br />C/}-' <br /> <br /> I II <br /> .__.._..L--.-J I <br /> Jacob North Printing Co., Inc" Lincoln. NE 68524 I II <br /> m <br /> iIC n ~ r-_,:o ~ <br /> m ::t: ~ o (f) m <br /> "'" m CI' '-= o ---I c::> <br /> c: <::>:> :D <br /> Z n :I: -"''\1... , cl> N m <br />('\ '" ,.-, e z-i C <br />x: S 0 ~ t\..' Z 4f'Tl 0 6; <br />." ~ (;") s;.- -<0 <br />t\ ~ o '''t N 0-" C) Z <br />~ :c en -"z <br /> ~ CO ~ <br /> t :z:: Pl <br /> ~ 10 )>G:l 0 <br /> r"f1 ::D <br /> P1 ::3 r :;0 c: <br /> Cl rJ> c..n s: <br /> (J) (f) ....t: m <br /> CO ^ ~ <br /> J> CO <br /> -:::: -"-" <br /> c...,) (J) CD <br /> Y> <br /> <br />NSTRUCTION LIEN <br /> <br />N <br />is <br />is <br />CO <br />is <br />(Jl <br />.J::>. <br />CO <br /><0 <br /> <br />~ <br />R <br />~ <br />~~, <br />~ <br />~~ <br />?\ 't' <br />~~ <br /> <br />CONSTRUCTION LIEN <br /> <br />200805489 <br /> <br />1. The real estate subject to this lien is: ':'4 a L{ ~ hm€LD.ef' f\v€-, lo-t ~) ~ loc1L. \) ~ f\ <br />\.JQst('o~S' f' ~b"t..lt~ ;5 loA b~ \ti ~~ ~ 0") }\ ALL e..o,.J "J.e.brc...~~'-'\ . <br />2. The person against whose interest in the real estate the lien is claimed is: ::5 \:.) ~ (\ K.' ( Q.. <br /> <br /> <br />3. The name and address of the claimant is: m ~ ~ '?,<'\.dc:hl).(._ '\- S~V- SQ.orJ ~ u""1 UGI.\J ~c9- ~ . <br />~C\',\e1 ) '13~ \1')' Abh,t~ R() ~r ML /;~~C?3 <br /> <br />4. The name and address of the person with whom the claimant contracted is: 3 v~~ ~ ~c...R..-l <br />'3 t.\lL\ "S~ hf"O.f1su.v Pt\~ ~T N L <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 />T r\,~ t 0\ \\ .e.c9 G\ (\ "-\A,'l- \ R....-E:.&' c,' e _\,.f) 0... \- 3 '\ ;1.4 j Ch ro~.f.r ~ .,.tL <br /> <br />6. (Complete one of the following) <br />1 The amount unpaid, whether due or not, to the claimant for the services or materials is $ 4-;A <54 , l~ <br />_ The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br />7. (Complete one of the following) <br />1 The time the last services or materials were furnished was .; ~ 2. ~ - o~ <br /> <br />- The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br />~)~~~ <br /> <br />~ GENElW. NOTARY. stale or Nebraska Signature of Claimant < _ "-- \. ' <br />JI. DENICE R. KRUSe o~ \'('\ ~ 1.<e1 ~a,~ ~ ..y~ ...,)""-!/,..:J, t..L <br />- My,,- ~ Sept 25, aJlO a, ~ <br /> <br />Subscribed and sworn to before me this U day of ~ ,~!B <br /> <br />.. - ..--~~ ~,(?,tG,t~ ~. ~ <br />GENERAl NOWiY ",',!,:': ;~ Nubraska ---------:-- <br />on';;CE :. ",l}SE Notary Public <br />7)- ,..;;:,," My CO/;::Ii r " ~'.5, 2010 <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 />-....1"1 I <br /> <br />II I <br /> <br />Rev, 9/~~ Ii" <br />