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RECEIVING # 943979
BOOK: 710 PAGE: 504
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
LIEN STATEMENT
STATE OF IDAHO
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County of Bonneville
In accordance with Wyoming Statute 29-1-301, the following lien statement is
made:
1. The name and address of the person seeking to enforce the lien is:
Shane Smith Drywall
3715 E. 20 N.
Rigby, Idaho 83442
2. The amount claimed to be due and owing is as follows:
$744.00
3. The name and address of the owner against whose property the lien is filed is:
Clinton and Cathy Harris
PO Box 3874
Alpine, Wyoming 83128
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4. An itemized list setting forth and describing the material furnished is attached as
Exhibit A.
5. The name of the person against whom the lien claim is made is:
Kinetic Construction Inc.
c/o Brian Heath
4595 E. Indian Springs Cir
Idaho Falls, Idaho 83406
6. The date when materials and/or services were furnished under contract is:
October 10, 2008
7. The legal description of the premises where the materials and/or services were
provided is:
Lot 48 of the Rees Subdivision, being part ofthe N Y2 SE 'l4 of Section 20,
Township 37 North, Range 118 West, Lincoln County, Wyoming,
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according to that plat recorded in the Office of the Lincoln County Clerk,
as Plat No. 171.
8. The contract documents that exist are attached herewith as Exhibit A.
DATED this / day of December, 2008
Subscribed and sworn before me this ¡'9fday of December, 2008.
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Acknowledgement
STATE OF IDAHO
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County of Bonneville
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On this L day of December, 2008, before me( k~l {l;( ()..Jt 5dY,}personally
appeared Shane Smith, known or identified to m'eto be the person whose name is
subscribed to the within instrument, and acknowledged to me that he executed the
same.
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Shane Smith itemized labor for 163 Spruce Alpine, WY.
Labor:
12.4 hours @ $60.00 pr hr: $744.00
Shane Smith Drywall
3715 E 20 N
Rigby,ID 83442
208-351-9833
- EXHIBIT
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