HomeMy WebLinkAbout934448
Prepared by, recording requested by
and return to:
Name: J::,.rtJ 13f,'c.I6(J/I _
Company:E rìc../&J,,, E ):Lç./~" ør5 .LAt.
Address: 10 ¡JðX 'I?lf
City: -fÁ¿4.f1.l., ~
State: tu'( Zip: '131;1
Phone:30J- 5go·- ff'l~
Fax:
RECEIVED 10/30/2007 at 11 :01 AM
RECEIVING # 934448
BOOK: 677 PAGE: 221
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
000221.'
----------------------Above this Line for Official Use Onl ---------------------
LIEN STATEMENT -INDIVIDUAL
(yVyo. Stat. §29-2-106)
COMES NOW, ErìrK60./} EX~éV~rc; J:/¡¿. , as a party who has
performed work or furnished materials for the improvement of the property located at and
~~Jed;t::: 1:"t::;'J1),~A~"-b w47 'rl3'fJ~M/'C Lblf'rr¡ a~
and woull state as follows:
1. The undersigned began providing labor and/or materials under contract for the
above-described property on the ~ day of $f'lZAt bv , 20/2L.
2. Work was substantially completed or the contract to furnish materials was
substantially completed on or about the l ',0 day of y 1 ' 20 o;il .
3. The undersigned has furnished the following labor and/or materials:
Labor/Materia/s ~tÍo jost/Value.
~(/?<.'¡-ld/1 #. () ~ó? /I ~8~ .].1..
, I
4. The undersigned hereby claims a lien against the above described property in the
amount of $ /~ 6 ~ ~ #..
This the J ') day of Dei/) her- , 20 CJ I.
d~~
~nature
STATE OF WYOMING
.
COUNTY OF ~~
~d subscribed to before me under oath this the øt q ~ay of
. , 20 tJ1 , by
who acknowledges that the matters and things a ed in the foregoing Lien Claim are
true and correct to the best of his knowledge as therein stated.
000222
NO~r
My Commission Expires:
(SEAL)
1-/5 -0'1
W'{ § 29-2-106
JOAN JENSEN - NOT~RY PUBUC
COUNTY OF. STATE OF
LINCOLN WYOMING
MY COMMISSION EXPIRES '7-/5-09