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<br />I\..) <br />C5l <br />C5l <br /><Xl <br />C5l <br /><0 <br />....... <br />....... <br /> <br />II I <br /> <br />---rr i 145 - C~NSTRUCTION LIE~ <br /><::('\~t'- <br />....... ,..", ~ <br />~. -4::.. ~ <br />~~~ <br />~ ~~ <br />~~~ <br />~ ~ ~ <br />,~~ <br />~ ~~ <br />~........ <br />~~ <br />~ <br />~ <br />W <br /> <br />Jacob North Printing Co., Inc.! Lincoln, NE 68524 <br /> <br />.. I II <br />i i i <br /> <br />~ <br />"ft <br />c: <br />z <br />2~~ <br />nen <br />~:J: <br /> <br />~t <br />n:z:: <br />~ <br /> <br /> ,~ <br /> ~ ('") (f) m <br /> c:= 0' <br /> QQI 0 --i ~ <br />~ c::::> c:l> N, <br />:;z --i <br />~~f' = -I/TI <br />~ 0 :0 <br /> -< 0 m <br />w 0 ....,., 0 ""0 <br />0' ....... .,., ,)> <br />'"T1 -"- CD <br /> r . (I) <br />IV ::r: m <br />m ::n l> OJ 0 Z <br />rn ::3 r ;:;0 en <br />0 r l> CD -'-I <br />u> ........ (fl ........ "~ <br /> ........ ;:><:; <br /> )> ....... ;. i!:: <br /> N ---- ~ <br /> CO <.n ~" <br /> c.n <br /> 5 <br /> <br /> <br />w <br /> <br />200809113 <br />CONSTRUCTION UEN <br /> <br />1. The real estate subject to this lien is: 1/'1 HI l;;lfJ- ..,..-r ~rAi/d :t~I/I~F&- <br />/rtJt "f 1}//1t/( J/ 7~ 4,//'5'-52:'/ ~L~//& A-r!t/,t;JN IYt TV ~':fy L?rtfr~ ~5/;f~<.{ <br />1-1/1'1/ t'..&,/,Mtj( ,v68r~'yf. ~. . . .. ' '. II> <br />2. The person agamst whose mterest m the real estate the hen IS clamled IS: k ;4 ~ E;;:/1 ,A/d c? <br /> <br />3. The name and address of the claimant is: <br />f{/) ~ ~jP'vF'ftvFtJc/ O~'. <br /> <br />~/1 ~ '7' 1'1~A'lIrEv <br />/J-rAlVd I7~, pJ'- ~ T?()., <br />f:A / /; ,/-"a' 0 <br /> <br />4. The name and address of the person with whom the claimant contracted is: .JJf. f, c <br />7/' j(/ Ii? fil oS ( ())' hf.-(/ ..z;1'/4~ ~6- <br /> <br />7b <br /> <br />fiI~ '11. <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: Fd~. r/~~ I""'~ 4,/ 1..I'............?r-If', <br /> <br />,A/L/t/ E/#ef~/(Jlrl ,7UV/C-tf ~4,9)l/e-/ C,ttJ.,... rL'f!-...r 1;'1~Cv- U-.er. ,'!-"tf- <br />" I <br />ft::A"t J,uf4J6-f.-,t-.e-( '4-. ~r#I/~-d J?; ~"'q ~F ~I/A-d J~I/I~-d i <br />6'/ ,/{!. '1-/1 '" (J~ / .$-;V~.6-i- . , ell'- ..49 API ;.wr~ r; t1P/.L't-p. Al,T tP /,-['(JEI/ 7 .?' L-?, 0 cJ <br />6. (Complete one of the fOllowing) <br /> <br />~he amount unpaid, whether due or not, to the claimant for the services or materials is $ J 7 IP?' " CJ 0 . <br /> <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 />Y The time the last services or materials were furnished was <br /> <br />JJ <br /> <br />Au d ~cPc) f <br />. <br /> <br />~ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br />c:~ ~~ <br />Signa of Claimant <br /> <br /> <br />GENERAL NOTARY - SIatB of Nebraska <br />KATHRYN A DESPINS <br />My Comm. Exp. - <br /> <br />< 3/dJf4t;YO~A;f:tJ/:pc~omR <br /> <br />Notary Pub~ <br /> <br />Subscribed and sworn to before me this <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 />JM <br /> <br />Rev. 9/9J rt <br />