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INSTRUCTION LIEN Jacob Na ?rintln IC Lincoln, NE BBM <br />(S % C� „ <br />CP <br />n� PQ x <br />d r o .-. <br />....�... ego 60 1 to <br />V - <br />200904369 <br />CONSTRUCTION LIEN <br />r� <br />1' <br />1. The real estate subject to this lien is: IZ ° /° v <br />l �a , <br />� Cr o <br />� /SUE �. -ri'S �► <br />2. The person against whose interest in the real estate the lien is claimed is: <br />DO v (L 5 iEr� <br />3. The name and address of the claimant is: L /;"4 , <br />4. The name and address of the person with whom the claimant contracted is: -5 Colll k. <br />W G Ld 5 ;° AT 60 5- L� <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: r— r u A--)"� <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ IRY . <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 />k The time the last services or materials were furnished was t" <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />Signature of Claimant 4-itj n C-r i- P1 4-61 °P <br />Subscribed and sworn to before me this `3 �� day oft <br />r <br />GENERA. NaTOY -State public <br />DONALD R. I <br />My Carom. Exp. Nov. 22, 2011 <br />(52 -147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52`154 for discharge or release). <br />Rev. <br />