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<br />22t•A MECHANIC S LIEN ~ 1 .~. ~ ~ ~ O (rj ~ Hoftman and Felton & Wolf, Walton, t1e. 580.51
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<br />Lisn/claimed tiy:
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<br />Dr. Cr.
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<br />State
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<br />Afftawt f+-st
<br />duly sworn, on his oath says that the foregoing itemized account of work, tabor, skill..._..._....._.._ ............._.._-....._......_...
<br />materials, and im ovemtnts is hue and correct: that same were done and pesformed and funlished by tht undarssgrted
<br />for the said---...~tRtsetDF L.~.h?!LT----------~-'- -----...11c::Llwlt.GC>lt.- --°--------°--------------------------------------•-•--•------------___.__.
<br />under a~ .---.._`.~~c.r.F.~l~.---•---- •-°-------•
<br />for the+...........11k~TC.(2.Q-T~.t_."i.....----------------------------------------af a ._..l-P..2 tfllf !~.-----. ~kt~~SC....----..fa.~.d7(._....
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<br />w.....~ w.....,..ng su..~jpi/eca ur pastel of tana,/ua:•.-...Gf.'.F..~f.__.._,13..-..-.S1..r:...._.L:c1.7...-.,3...._..~i.Yd --..(.~~~..-.:G9!~......-.
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<br />That at the time said contract uros made and labor and materials furnished and deliversd theseundt-..........._......-....
<br />~fctfF.ti.t...----5...._~r....~..~.tlt.i.]-~.t~......~~..[k? ..C~...-..--- ...................................was the o~anner of said Qremiser'
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<br />That the date of the ,first item furnished and dtliaersd :ws._..._~F.4.~.f2t~~.i.F..._....,~-1.~.~'L~'_..._...,.- atad. tlis
<br />date of the test item was.-.-.r~!4tthlt.AA..y7'-----..3.1f_._l~f.~.~..------°-°-•--°------°------------------------•-_• ............._..~.........-..-•------...
<br />Afjiant further state that said tabor 4rra,r parfornlsd on. and materials wsre furfeisltsd for, daliowed ot, and: r~-:fn=
<br />said building or gemises on and batweau the Batas spscifted. ,
<br />That the pricss charged therefor are fair and reasonable, and that there u t~ow~d'-~ ow said, actowtt tlts swN of-
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<br />•--......___ ........................°-,..-•--_.......-claims a lien. an the satd prsmiices fo-<tltit,,rll_atnrtwti of
<br />said account, to-writ: Tks sum ofd....p...7-pc~~.~r~.+~.....7_'L .................._togatlta witA ints'r~tl=tl~art4tF,at,.tht, is~a1. Nottf.
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<br />S ~Mlrb S~seribad is my pressrtce attd swiirti to befars >frs tllu.. ~~~ _- ---- -~ ~'
<br />lL~~ _.at* cMw. Bea. sw s® 9Mt da o rrr I .f f u
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<br />( see reverse side for itlstructirntsj
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<br />cauncx .............. _.. ............................._ ._ ..... ~ ea. is the ~ n~f Acad.•OS9ce t~ .nla .
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