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<br />II I <br /> <br />N <br />S <br />IS) <br />CO <br />is <br />CJ1 <br />CJ1 <br />-->. <br />IS) <br /> <br />I II <br /> <br />I II <br /> <br />Jacob No~intln!l Co.. Inc., Lincoln, NE 68524_____6JJ-- <br />c- ~ c> U) <br />'-..,! '0 0--; <br />...-"..' C-"o c:;p. <br />~ ~~_' ~\OO ~;:ri <br /> <br />0", ~...." -< 0 <br />o ''oJ 0-" <br />'"T1 0') ....., <br /> <br />g t~.t =c ;;; <br />rT1 'j -C > co <br />t::> :3 r;o <br />(I) I;p. <br />f--.4 (f) <br />:::>0;: <br />;to. <br />",--""""""--' <br /> <br />~STRUCTION LIEN <br /> <br /> <br />~~ <br />rn CI) <br />n:c <br />;pc; <br /> <br />o <br />N <br />o <br />c:> <br />CO <br />a <br />c.n <br />c.n <br />f--.4 <br /> <br />S <br />CJ:t: <br />~ l-.i V\ <br />~<1 <br />H- "<; <br />v (ti <br />-UJ <br />~ ~ It::> <br />~ '(\1 <br />11\ <br /><: ~> <br />tn 3 <br />V\ <br />~ <br />~ <br />~ <br />~ <br /> <br />70 <br />m <br />"'" <br />c: <br />n Z <br />~~~ <br />('\(1) <br />,.;:X <br /> <br /> <br />.....J:: <br />0') <br /> <br />~ <br />(.f) <br /> <br />o <br /> <br />200805510 <br /> <br />H <br />.::;; <br />('"3 <br /> <br />I <br />(p.oo <br /> <br />CONSTRUCTION LIEN <br /> <br />1. The real estate subject to this lien is: Lofs lo...!4 / Block./) ~oush Su.bd; VI's/on I <br />(t,ra."d T'S,\tlf\d J t-IClll ~ou..,..y~ y, N en ("a~lO- <br /> <br />2. The person against whose interest in the real estate the lien is claimed is: Dc')u J <1aJ+ 0 <br /> <br />3. The name and address of the claimant is: ~Ltar~ ~SiCj(lS)--r.l1c..'1 L!-I/). vJ. ~fdst'l <br />C::>fUJ'd 'TSIGtncl) l-.jwrasi:R. ~gg()1 Phone. 3'6t../--/0t;3Lt> <br /> <br />4. The name and address of the person with whom the claimant contracted is: <br />\:)c,~ ~Ho) SL/-5 E. S+()\\e'll6.rk. Rd.) C7n:trd -Lslond, NE. t:,ggOl <br />5. A general description of the claimant's services performed to, !? .b! perform~ or m~~a1s ftu1Y.shed or to be <br />furnished for the improvement and the contract price is: fY\~l i r.J '" 1 u / n 1~CL...t:!-) { <br />h:,ME.. '11Y) ?(o>JeiY'\e~ well?... r~fUfr"c..t;le. ,'0(' kAcnet)j ail neuJ kAd\€x, <br />Clubif\cls,euf~J-<1-pa-d ",or I; JI~ foO(Y)/t'Qvn;ly room:i 5 ~d fDoms, <br />6. (Complete one of the following) <br />l The amount unpaid, whether due or not, to the claimant for the services or materials is $ ~ <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 />+ The time the last services or materials were furnished was ~I r!1tJ J ~ 00 C6 <br />_ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />M Squ.at~ hsi~nsl T../)C . <br />~/C~e.. MP a~ , <br />,~~n ~ <br />~~~e 1ai ant <br /> <br />Su <br /> <br /> <br /> <br />, ...t1lc1i. <br /> <br />,,'\lW~.. <br />l~'~li">i"" <br />i ~NE"...l\ ~ <br />.* NOf:'~yi*g <br />\, ....'*'..l <br />'I.,,~.~j-,.... <br /> <br />MARCIA L. SIEMERS <br />MY COMMISSION EXPIRES <br />January 4, 2010 <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 />lrr- <br /> <br />ReV~~~/9r-TI <br />