HomeMy WebLinkAbout917388
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WHEN RECORDED MAIL TO:
Kelly A. Silvester, ESQ
P.O. Box 1203
Bountiful. Utah 84010
RECEIVED 4/11/2006 at 9:31 AM
RECEIVING # 917388
BOOK: 616 PAGE: 677
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
LIEN STATEMENT
NOTICE IS HEREBY GIVEN that the undersigned Lien Claimant hereby claims, pursuant to the
provisions of Chapters 1 and 3 of Title 29 of the Wyoming Statutes, a lien against the real
property located within the County of Lincoln, State of Wyoming, as more particularly identified
herein. for materials and services rendered for improvements to or upon said property, as follows:
1. NAME AND ADDRESS OF LIEN CLAIMANT:
/
Brundage-Bone Concrete
Pumping
350 West 750 South
Pleasant Grove, Utah 84062
2. AMOUNT OF CLAIM DUE AND OWNING:
$861.18, together with interest,
recording fees, attorney fees &
collection costs
,0
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t..i
3. NAME & ADDRESS OF PERSON AGAINST
WHOSE PROPERTY THE LIEN IS FILED:
Harold & Donna Andrews
497 Toms Canyon Road
Auburn, WY 83111
IC·
Copeland Revocable Trust
Box 4141
Bedford, Wyoming, 83112
4. ITEMIZED LIST OF MATERIALS
DELIVERED OR WORK PERFORMED;
Concrete Pumping, equipment
& labor as set forth in Exhibit
A, attached and annexed hereto.
5. NAME & ADDRESS OF PERSONS
AGAINST WHOM LIEN IS CLAIMED:
WATISENT.
P. O. Box 1602
Afton, WY 83110
6. LEGAL DESCRIPTION OF WHERE WORK
WAS PERFORMED:
T'
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09:l?:l88
COC678
Tax ill # 3418-27-3-01-025
Lot 84, Bridger Forest 7th, as
recorded in book 350 at Page
620 of Lincoln County Records
Property Address: 768 Strawberry Creek, Bedford Wyoming
7. FIRST DATE MATERIALS/LABOR
AND SERVICES PROVIDED:
November 29, 2005
8. LAST DATE MATERIALS/LABOR
AND SERVICES PROVIDED:
November 29, 2005
VERIFICATION & NOTARIZATION
State of Utah )
)ss
County of Davis)
KELLY A. SILVESTER. being first duly sworn, deposes and states that he is the
authorized agent for Brundage-Bone Concrete Pumping.. the Lien Claimant, that he has authority
to execute the foregoing Lien Statement on behalf of the Lien Claimant, and believes the contents
thereof to be true and correct to the best of his knowledge, infonp;tjon & belief, In witness
whereof he has executed the foregoing Lien Statement on this -ILL- day of April, 2006
J./) SUBSC~ED AND SWORN before me, a Notary Public for the State of Utah, ðn this
ØL- day of Apnl, 2006
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APR/07/2006/FRI 10:20 AM
Apr Q1 os 1~:21a
Brurxiage-Bone
RFFltllTY ESCRQW
FAX No. 801-785-9628
901938100G
P. oODe 67'9
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IŒU.Y A SILVEST....
AUonIey at taw ~
P.O.Box 1203 ..,
Bc:w..,~ Utû 8401-:
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PHONI:(801)292-5436
Mardt 23.2006
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Watts I:a1.
P. o. Bolt 1602
Alton, WY &3110
Harold a: Doaaa AncIRws
491 Toms Caayoa Road
Aubum,. Wyomiug. 13]11
CERTIFIED MAJL
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oR.!: Labar.. Setvice, !qIIpment Of MIÞrW F.....,~cd by BRUNIMGB~ ~~~ ~
t.oJ1SImcôoøprqjed:bowa"~IYCnelcPriwdD.Rœd o. --',1-'(:" '~.O~
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To Yr nœn ~~ '::....:c:..~~":'"_" .. ~~":o ==: '" .
PJeue take notice 1hetB1lIJNDA.œ-BoNl! CoNcuni PDNmIG.INc"2 Jaai fbmishecllabor. services.
equJpmear or material to )'OUr CCWInIctÌoD pfojc:et Joc::aœ4 at: 0 0 0
768 Srmwberry CI'CC~ 'dwre Road
The amount doc and owio&.is $161.19:
,00
h..
Pwsa.t to Tille 29,. CIIrpIIb I a: 2 tllbe WJQIDÏø& ..... \!lID __ Jða 11m: ~BoNB
CbNcItE.'mPOl.tPlNGk..... ..will................ ~1'.... « .......... to dic'~aiIJc!d
pcoja:t aDd dIat& ~,......, ....10...,. of1ll:.., of'6is Idtu file a liat 1bL....- tor ~
value otdJolllbor..mco, tIIþ-,--H or....... ~
EdcIaa pIeasoWarqty of. LIaa ~ e.~ ~ filed it.. r....... CoaIy~ This
does lICIt inlplyU...IieD'" lay .....:.-.....,. oaIy to advise)W that BIwNDAGË~ 0
CONCIŒŒÞouPHJ. k.._..wiR......~ ~ ~QI"_~ OB'Ibe.aIJoyc
sblklll jcIh .... to ....,. to 8liç1lle ft . y 1IqIe,.. ÎIISIIœ tll:ltpaper'JIINIIIcaIBIIIiIdC,
dIereby avoi"liaafilillpør~ . I.~"" Ja1beO¥altof~ UIe,;ua~ duo
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àR/07/2006/FRI 10: 20 AM Brundage-Bone FAX No. 801-785-9628 P. DOC 0 r 680
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091.7:.188
IJrata Bk"a1lC:b · 350 Welt 700 ~h . 1'IcasaDt Grove U'I' 84Uft~
Plaoue (801) 1~-~803· Fax (801) '785-9618
I. .---- INVOICE -_..:... I
Page No.: 1
î 1/29/2005
lD:voiœ No.: 0181444
}JiWng Address
Site AddnI.. - W A TENT-OO 100
WATfS ENT.
P.O. BOXIQ)2
AFTON WY 83110
SmA WBBRRY CIU!:EK }>}UV A 'I':E RD.
BB»}õO:RD
BBDFORD WY
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Phone: 307-6~7~S I?AM~ WC\+ts T~: NET UPON RECEiPT
YIII1Ù Pumped: 24.00 Hours Billed: 4.00
Job Date: 11/2912005 Work Ordcr: 181444
Salesman: 006 P/O: NI A
Lots: N/A
S.1ze Jt.oqoested: 32
PwnpNo:352
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QuUJti\Y
24.00
:V6o
1.00 ea.
1.00
1.00
Unit
çyds
hn
Description
YARnAGE CHAIWn
ao'OlU. 'Y CHARGE
TRAVEL CHARGB
FUEL SURCßA)lGE
SLUlUl'Y @ $10.00 PER. BAG
Prlçe
.:. 2.7S
113.00
50.00
35.00
10.00
T~
Line Total
66.00 ~-
460.00 -3'16. tJ'O
SO.OO
35.00
10.00
An Equal Opportunity Bmployer
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