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lam'. <br />rxsrRVCriol+ts: <br />(t) If the ticn is tlainttd by a frm or corporation, state lure that aQsant is a member of tlu f~ or his <br />offtcia! capacity its the corporation- <br />(r) State hne whetJFsr vsrbot or written contract. If uviteett, attach. cagy, ar tics is void. <br />(3) °Erestion," "Gonstrwction;' "Atteratwn;' o- "Repair," as tht care tray be. <br />{;) }Ierc insert torrent legal description of -land. <br />{S) If the-tabaraxd material were furnished tks contractor and net the oumer direct, state "that..-_--•-----°..- <br />war the contractor an said brritdiag and acting far the awaer.,, <br />{6) If Hots has been given, say "said atnotrnt is fterther evidenced by a promissorynote, a cope of said nou <br />being hereto atttuhed and marked `Eshibit B :" <br />J ~ '- <br />-, <br />~, <br />3 <br /> 4 0~.~ m <br /> <br /> <br />C c n <br />~ ~ <br />~ ~ <br />~ <br /> ~ <br /> ~ <br />~~ <br />N ~ m <br />O ~\ <br />3 A fY7 <br />t <br />~ <br />1 <br />1^ <br />Af q ~ I <br />J <br />~ <br />~ rf <br />as1 y_ I P <br />{ ~$ <br />v <br /># 3 <br />tD <br /> t~ <br />~. I <br />' <br />i <br />1 ~ <br />~ ~ ~'- <br /> T <br /> <br /> <br /> <br /> <br />