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~, <br />`~ <br /> INSTRUCTIONS: <br />(a). If the lien is claimed by a firm or corporation, state here that affront is a member of the arm or his` <br /> ofRciut-capacity in the corporation. <br />(a) State here- ihsr vc-b[d orwrittsn contract. If written, attach copy, or lien <br />is void. <br /> (3) "Erection," "Canstrnction;' "ltlteration," or "Repair," as the Gass may bs. <br /> (¢) Hstra insert Garrett laga! descriptions of land: <br /> -_~s) If the~l4bor acrd-_tndtelia! were furnished the,c.,ontractor and ftGl•-:the owner:drrect,-„state "that::.. ..uw.:.. <br /> was' the totttractor on said bnitding ~' ratting for the Denser." <br />(6) f f xotc has been given, say "said anroxnt is fnrthar evidenced by a promissory Hots; a copy of acrid noes <br />\ being hereto- attached and- maiked. 'Exhibit B':" <br />~\l <br />~. , <br /> <br /> <br /> ' <br />\ <br />E ~ ~ ~ ~ sr c \ <br /> ~ ~ ~ ~ ' ,s ~:: <br />ar J. t3.. h t ut <br />~~~ 4J <br />C. <br /> +~~ <br />'till l~ -:. <br />.7 ~ ~ li ~}i C'~1 .i <br />.Y <br />1 ~' <br />1 , <br /> _ <br />~,. C:J C7. t;i f- p~ t4~'~~ ~ :L <br />~ <br />~'~ Y~ <br /> <br />- C <br />W 1 <br />r-- fee .. <br />6~'f3 ~ <br />