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<br />~~ <br />h , <br /> <br />O N ° v; <br />~ <br />it ul t .f <br />r-+ <br /> <br />41 <br />C ~ Sp ... l•~„i <br />0. ~ ~ <br />~ "~' i <br /> <br />G7 ~.-.~ -c-.: 1 G.: <br />__. ` ~ <br />--. ~_ <br />Y <br />N <br />- ..« <br />~ <br />m , ~. <br />~ <br />o <br />} <br />~ . <br />- _` <br />' \L <br />~ v <br />r-. <br />i, ~ ~ - ~'-- <br />[iJ SJ ~ <br />~^•- <br />t~Ni <br />i <br />I1;"S'TI2 UCT ICI ~V5 <br />(r) Ij tlEe tier is claimed by a ~irna or torpc>ratiox, state r'eere thad want is a nse*tnlter vj ti';ar (rrrr., cr /zisr <br />o~itial rapacity in the torparation. <br />(z), _$'ta~~t¢ iierq ~ohether verbal or xUrritt~wt coxtra~r#. A# slaritten, a¢~~ttarls eapy„ rar liemp is void. <br />i3) "Rrettion," "Construcfiox," "fllteration," or "Rspair," as the rase shay be. <br />(¢) Here insert rorrect legal description of land. <br />(5) If the tabar and material were furnished the tantractor and not the owner direct, state "that ............._... <br />was. the contractor ox said building axd acting nor the oremer.° <br />(6) If note has been given, say "said a»wunt is further rridented by a promissory rote, a copy of said noft <br />being hereto attached axd markad `Exhibit B':' <br />~- <br />~' <br />.~ ~ `-.~ <br />k ''`f* <br />`t~ <br />J~ <br />~(~ ~ <br />y <br />V i! <br />a w <br />~~ <br />~~ ~~ <br />