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ISTRUCTION LIEN <br />Jacob <br /> ~ <br />: <br />~~ <br />IV ~ ~ <br />~ ~ <br />~ <br />= <br />~ ~ <br />. <br />~ ~~ <br />~ ~.. <br />~ <br />~~ ~ <br /> <br />`~' <br />~~ ~ ~~ <br /> <br /> <br /> r~ ~. ~, <br />~; <br /> c <br />i ~i o ~ <br /> <br />~ _ ~ <br /> 4 <br /> <br /> 200904370 <br />CONSTRUCTION LIEN <br /> <br />/~43 ~/~~~ ~au~se ~~arra/ /sl~rrr~ ~~ <br />1. The real estate subject to thins lien is: <br />2. Th person against whose interest in the real estate the lien is claimed is: ~~// ~/~~ L~4~[lC.,..;` <br />D 8 . ~ ~e v L~r / /N ~Coc,~ ~f a~= ~l/r~/m~P~/-~ r,~~ ro ~ ~~ry ~~G/a~! <br />8. The name and address of the claimant is: <br />~,~ ~~r~ -~ ~P~~ r <br />4. The name and address of a person with <br /> ~.~ <br />- <br />m <br /> ~, <br />~ ° <br /> ~~~ r Q --~ r.~ <br /> <br />~ w <br />~~ ~ ~ f'V ~ <br /> <br />~' <br />~ ~ fT1 <br />~ ~ <br />~ <br />o ~ ~ ~ ~ <br /> ~ <br /> ~ <br />C7 \ ~ t <br />rl <br /> <br /> ~ <br />~ ~ ~ -~ <br /> ~ <br />W C <br />~ <br /> W ~~ ~ ~ <br /> <br /> ~" 2 <br /> O <br />/, <br />hom the ~mant contracted i <br />/,vs . C~)~~eta~a ~~~ <br />5. A general description of the claimant's services performed to, to be performed or materials furnished or to be <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ ~~-3• ~° <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) q <br />~he time the last services ox materials were furnished was ~ ~ <br />The time the last services or materials were furnished has not <br />occur <br />ure of Cl 'm t <br />Subscribed and sworn to before me this ~__ ....._ _....~ day of~ ~~. v - - . -- ` . <br />~~ ~~ <br />Notary Public <br />(52-147. See 52-148 for amendment; 52-149 for assignment; 52-187 for recording time; 52-154 for discharge or release). <br />~ae~ ~ .. <br />~~N ~ saa or Nwarirsk~ <br />~~1.~Q~~ (IA~Co(Ipllission E+'c. ~~~ duo t, 2017 <br />