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CLAIM OF LIEN
STATE OF
COUNTY OF
BEFORE ME, the undecsigned NatlL')' Public, personally appeared Warrell Webb, who duly tswom
:<:ays that he is the owner whose address isP_O_ Box 402, Thayne, WY 83127 and that in Ilccordancewith
the agreement between 1ienor, SUbcontractor ana Contnlctor namely Triple A Construction, Blackfoot, ill,
tbe servic~ of 1 Forklift was provided' foc the dales of April 16, 2001 through May 11, 2001. The seIVices
were provided to the following described real property in Lincoln County, State of Wyoming. Plat 01 Lot
13, Star Valley Ranches, Lincoln County, Wyoming. The total value-or One thousand Eight Hundred
Seventy Five dollars ($1,875.00)ofwmcb there remains unpaid $1,875.00. As required the lienor served a
copy of the Notice of Intent to Lien on the owner, namely, Larry Dunnagan and Kar,a Dunnagan on June
] I, 200], by lienor Warren Webb.
/A.,J 41' I' e- ;J
Lienor
BY._~) C2~
Agent
On ,:-j'I.J.\.t ;:) tdOO' before me, l;;U rlEf\ ~ bb , penonally
appeared h'):l..'r'rt \1 l ^- 'f bh , personally kriown to me. (or proved tome on the basis. of
satisfactorY evidence) to be the person( s) whose name( s) is/are subscribed to the witbin instrument and
acknowledged to me t~t beishe/they executed the same in his1hec/their autborized capacity(ies), and thai
by Jlis/her/their ilignature(s) 011 the instrument the pefSOll(s), Of the emit}' i1poil bebalfof wllic1f il~
person(s) acted, executed the instrument
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WITNESS my .hi'l11d and official sea!.
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S.gllatute
Affumt...............Know~Produced ID
Type of ID.tr\\)f r:<:. \ "(\0 n.$.lL.
(Seal"
BRANDlE MCDONALD. Notary Public
County of State of
lincoln Wyoming
My Commission Expires February 13, 2005
814280
RECEIVED
LINCOLN COUNTY CLERK
o I JUL - 3 fJ1 8: 3 I
JEAN N[ \tii\CN EH
KE'MMEFlEr~. 'WYOMING
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