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_ iii i _1i ~ JS7RUCti4N LIEN Jacob North Prlntin Co, Inc. Lincoln NE 68.524 N B N Cn W _._~~_ ~~ ~ CJ --1 ~r ~.. ~ d 6 C.l7 ~ ~ ~ ~~~,j nV ~ "V -'~ 77 C1J C~ ~~~ ~ `v l~_ ~ ~ ~ ~ ~ ~~ a b-~ m~ ~ CONSTRUCTION LIEN ~ o ~. O o 2 5 0~ 1. The real estate subject to this lien is: '° K ~.,D /s~,.~ .tit ~&~o ~ ,Z vc d .rausF/ v-is .s ~ 2. The person against whose interest in the real estate the lien is claimed is: ~~U 3. The name and address of the claimant is: Pc-uR~ ~/ s .~ / I ..urrr _ 4. The name and address of the person with w~ho/m the claimant contracted is: ~GrL.I~~~~~... _,_- __ ,~~'~S~ C ~/oL,Lc~/ PA~w'! K.~ • 1 ~/~s~.JD ~S~A~. /U~ ~n ~1~ I 5. A general description of the claimant's services performed , to be performed or materials furriis ed or to be furnished for the improvement and the contract price is: ~ / s IDiQ. f ~ j ~ 1/ /CY r ~ / _l,~ f /~.a~n-l.~-s. /~'1Ddf,,O GJgI~ rEt ~r~ ~Fr~-+~+e , f ~'~~r~_n. _~r~~,~1. ~,arE,~ /e Clrur~~ LraCS Fva. lL'~/tE~`'• /~~fl4EQ ~7zt-~. ~ ~,n.Y,[ ,` ~r.5/Iw19~tlE~ • J'~~T Te7iiLSi ,{ ~q.~/ TL~'!~3 • ~c~J'iFitC~rJ 6. (Complete one of the following) ~t-cM~~rs ~.r lJ~~. i,~c~r~,e. ~ ri.~~ S . The amount unpaid, whether due or not, to the claimant for the services or materials is $ ~~~ ~~. ~' The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ 7. (Complete one of the following) ..~.. The time the last services or materials were furnished was ~~/~~~~r> /y ~~ The time the last services or materials were furnished has not yet occurred but is estimated to occur Signa Claim ~AI ~ ~cNTZ , Subscribed and sworn to before me this `C~ day of _ ~ ... _... ~~~ . ~~ GENERAL NOTARY - State of Nebraska Notary Public IIY 57ACEiY A RUZICKA ~~~,. ~ _ _.. My Cnmm. Exp. May iD, 2011 (52-147. See 52-148 for amendment; 52-149 for assignment; 52-137 fox recording time; 52-154 for discharge or release). _ Rev. 9/9$