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<br /> 1. The real sstat� srebj�ct to this IIcn is: 2707 W. ist,Grand Island,Nebraska 68803
<br /> LEGiAL D.�SCRIP'1'ION: Lot Eight(8),Block�ifteen(IS),Ashton Place,Grand
<br /> Island,Hap Caunty,Nebraska.
<br /> 2. 'II'he person again.gt whose interest In thc real estate the lien is cluimed Is: Velma O'Brien
<br /> 3. The name and addresa of tlte person with whom the claimant contractecD is:
<br /> Velma OBrien
<br /> 8707 w. ise ��
<br /> (3rand Island,NE GRa�� �
<br /> 4. The name anci address af the claimant is: Co��a�er Roofing Co.,Ina
<br /> P.n.�cax 591
<br /> ?�9 W. 16th Straet
<br /> York,NE 68457
<br /> 5. A general description of t�+ie claimant's se�riccs perfora►ed or to be performad or �
<br /> materials furnished or tcr be furnished for the improvement of said real estate and the
<br /> '."�.3:2ti°^ �^.Ilr�w ic: -
<br /> Tear off e�dstin�roof and replace with new roof.
<br /> b. Thc amount unpaid,whether due or not,to the ciaimant for xhe servIces or materials is �
<br /> 5500.00.
<br /> 7, i1�time the last senrices or materials w�re furanished was: May 20,199b. �
<br /> CONNE��ROOFdNG CO.,INC.,Claimant . . � •
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<br /> SUBSCRIDED A?�TD SWORN ta befare me this /�r�' day of September,l9lb. .•
<br /> iEillL IITA�1'�M M�lad� .
<br /> Y11�MIIESi.00[�J. �
<br /> ��E"�`�n'� Notary Public
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