HomeMy WebLinkAbout02-5334MATERIALS AND LABOR
TO WHOM IT MAY CONCERN:
t-ontractor") has been employed tiy~o.~,~,,~-~ ~ ~ l~C~ (herinafter "Owner") to
m~sh l~or and/or material for com~mc~on work on pro~ny
S~aee of ~X~'~ owned b' ~ne
' . y r, prO~er~y ~s m~her ~s~ in ~ee~
r~ord~a~8ook~ ~ ,Paget, s) _55~ in,he (~~
Coun~ Regis~ of Dee~s, - -~'
recei~ of which is hereby
~knowledged, do berry waive ~ r~ease any and all liens, cI~ims, or rights to lien ~e d~crib~
premis~ unaer the statu~ of the SmSe of ~ ~X~ ~ _ rela*ing to Meehani~ Liens, on
a~oum of labor ~/or materials, ~mished by t~e ~ersign~ to or on ~count of the said Owner tbr
the above d~rib~ prmi~s.
Signed this .5:0'~'- day of
STATE OF: p ~'
COUNTY OF: ~'R8,4/,~ [, '-
(Contractor) who acknowledged that they executed the foregoing inslrument for ~h¢ purposes therein
¢onraimd.
NOTARIAL SEAL
I ,.,.m~u.'ur~ourg, i-ranKIin ~
L_MY Comm~ion E~iree O~