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79005518
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Last modified
1/13/2010 4:35:14 AM
Creation date
1/13/2010 4:35:09 AM
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DEEDS
Inst Number
79005518
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<br />Ixsr~xrlcrra~vs: <br />(r) If the lien is claimed by a firm or cosporation, state here that affiant is a member of tl:e fism or his <br />of~ecial capacity in the corparotion. <br />(a) Stott here whether verbal or written contract. If written, attach copy, os lien is void. <br />(3) "Ereetion,» "Construction," "AUeration,» or "Repair," as the case may be. <br />(¢) Here insert correct Isgal description of land. <br />(s) If the 1-bor aesd matzrial were furnished the contractor and not the ozoner direct, state "that .................. <br />was the conttnctar on said building and acting for the owner." <br />(6) If torte has been given, say "said amount is further evidenced by a promissory note, a copy of raid note <br />berng hereto attached and marked `Exhibit & :" <br />1.~~ _ <br />~~ <br />~^~' <br />`~T <br />~ Y ~ ~ ~ ~ - <br />m f `~ <br />~. ~~~ <br />_~~~ ~~~~~t f ~ ~ <br />C ~ ~ ~ ~ ~ ~ ~ <br />4! O = fJ~Z <br />o ~ ~~ <br />~ ~ <br />1 y C b <br />i i d o I~ r <br />~ ?~ <br />1 u ~ <br />La ~ a ~ _~ o ;~ c 3 <br />II ~ ~ <br />. ~ - ~ S ~- a I~~ <br />II Il II a ~° ° •~ jl ~ s <br />r ~ .x ~ li ~ <br />lllf `~.~,_o~ ~.. C~ <br />
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