HomeMy WebLinkAbout05-2540
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n... b'{. d,:"-"o yv,LO IL-
Claim of Lien
~~~i~~~trla
on the following described real property in
State of VP 1I1l5L/-, \i0lJ\\G\..
(D scribe real property sufficiently for id€ncificaticn. including SIr.,,', u'ld number: BI
I. :1013______H_
CLlj.
Cardet ~ t-e_ l)(j
owned
by . ::.CL. of a
total value of - illluncl(fC~0IlarS($I~)!o50.00)
of which there rerr,ains unpa;a Iwo'-fhou."C d}i Uill....~1lfDollars ($ ;:;J) do 0,3.00 ),
and furnished the first of the items on HGlrc _ h I 0 ,20 05' and the last of the
items on _H n r LI, L:S 20 r6 and (if the lien is claimed by one
not in privity with the owner) thaU!!e lien0r served his .notice to owner on l'l pr I L.. ;).9
2005" by----.U~. ~nSt{l Ii. Se\\fIC..f'_
(MNhor; DfService)
Ar,d, ~i' ,o4uired) that the lienor served copies of the notice on 'ne cor tract on
20 ,by__
, and on the subcontractor
(Metnod of Servict:!
on 20
lender
, by
, and (if known) on the
, on
, by
(Method 01 Service)
Piq~ 1
W>NW.><xrate~.(om
(0;'004. SOUdlfsMfdia, llC
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.
Signed this
7~
Lienor:roC€illen~ DoctDr 1tJC\.-te'Ps.oofl~ CO.
litJ +Iv day of
.-
,20 D:S
By: y1~ ''ln~
'Officer or Age t
State of ~--d-~}
County of ~
On ,20 oS before me, .JO'jC t: tYl (:.-Ioaf-
appeared IlL . e-l1. e
personally known to me (U proved to me on the basis of ,,,tlsfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to m~ that he/she/they executd the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature OF P
Notarial Seal
Joyce M. Frost, Notary Public
Lower Sout~pton 1\vp", Bucks County
My CommIssIon Expires Apr. 9, 2008
Affiant _Known~ Mambal, Pe""syl,acc;, Association of NOtarIes
TypeofI01A~ .~
(Seal)
Page 2
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