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<br />~STRUCTION LIEN
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<br />Jacob North Printing Co., Inc., Lincoln NE 68524
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<br />200510195
<br />CONSTRUCTION UEN
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<br />1. The real estate subject to this lien is:
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<br />L €-e; 1'/-1- P1 eNI4l.<-l .s;)( +J.... s ,__1, La 1-.2
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<br />2. The person against whose interest in the real estate the lien is claimed is:
<br />2- 7.-~O /IIo?/-J.. :r:>;~ ..-J' /}ve \ G-:r ,;LIe. 6 ~ J'D3 ~
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<br />3. The name and address of the claimant is: If/ebr. f2 ~-b) / t:Js-?/ ; ..r:: elf. J/W7 t 7ZZi f
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<br />4. The name and address of the person with whom the claimant contracted is: C,S C- I T/'J <:. .
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<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 />~,___i.ll!/ C1 eA. y.-.~---f /1.33 6 9~6
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<br />6. (Complete one of the following)
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<br />_ The amount unpaid, whether due or not, to the claimant for the services or materials is $ 36. 1-
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<br />_ The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ .
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<br />7. (Complete one of the following)
<br />~he time the last services or materials were furnished was ]) tAy,<......S ;t}~ tA-V' f..., p;.I""':.f1 dd-k '7 hie.
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<br />_ The time the last services or materials were furnished has not yet occurred but is estimated to occur
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<br />Subscribed and sworn to before me this
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<br />GENERAl NOTARY - State of Nebraska
<br />STACEY A. RUZICKA
<br />MyComm. Exp. May 10,2007
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<br />(52-147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52-154 for discharge or release).
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<br />Rev. 9/9
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<br />II
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