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HomeMy WebLinkAbout958154STATE OF WYOMING SS. COUNTY OF LINCOLN F. Michael Kibbie P.O. Box 5258 Etna, WY 83118 STATEMENT OF LIEN RECEIVED 2/16/2011 at 12:5b r-ivi RECEIVING 958154 BOOK: 762 PAGE: 610 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY 000610 WHEREAS, the Claimant, Call Ready Mix Lumber, Inc., of 786 N. Washington, (Mail: 88500 US HWY 89), Afton, County of Lincoln, Wyoming, 83110, has directed a Notice of Intention To File A Lien on the 28 day of January, 2011 to: advising said above named party of its intent to file a materialman's lien against the buildings and improvements located on certain property situated, lying and being within Lincoln County, State of Wyoming and herein after being more particularly described, and further advising the said owners of the amount of the claim and that the claim was due from Flat Creek Concrete /Tom Holdren for concrete supplied to the Kibbie's residence and that the claim to date remains due, payable, unsatisfied and in full force and effect, and therefore, Call Ready Mix Lumber, Inc., claimant herein, states as follows: 1) The name and address of the business seeking to enforce the lien is: Call Ready Mix Lumber, Inc. 786 N. Washington Mail: 88500 N. Hwy. 89 Afton, WY 83110 307 885 -2255 2) The amount claimed to be due and owing is the sum of $3,442.04 3) The name and address of the persons against whose property the lien is filed is: F. Michael Kibbie P.O. Box 5258 Etna, WY 83118 4) The lien claimant last delivered concrete to 1195 Trail Ridge on 16 of November, 2010. 5) The amounts due and owing from Tom Holdren with Flat Creek Concrete for the concrete provided to the Michael Kibbie residence are set forth in the attached copies of the actual invoices and are made part here of by reference. 6) The legal description of the premises where the concrete was furnished is more particularly described as follows: Physical Address: Legal Description: 1195 Trail Ridge Road Shadow Dancer Estates Subdivision, Lot 17 T36N, R119W, Section 10 TOGETHER with all improvements and appurtenances thereon. THANK YOU Please keep this copy for reference QUAN. fee A, Q- i .S 4L 1-0 O Ssaa�t N k1 DESCRIPTION TOTAL TAX I PRICE I At �t� 1.5 ---j— .6 1 :::41:;• ft 0 0 4 z N 5 al 0 g 7 I P 0 Z a. 3 -9 i CD 0 0 1 0 00061t 0 rn C% 1i J Total Invoice Amount Payment/Credit Appled 4,'+';'4Vil:'-'1,374*;RW'SONF;,atiFtlfefftr 17474' Icp 4 4 4 ./4 43 8 8 8 2,t07-585-2255 307-585-0850 RF DY iln.) 'N.. 'WASH NGT ON MI-YL: 88500 N. HWY 89 'NY 83110 USA FLAT CREEK CONCRETE' P.C. BOX 101 MOOT, WY 83125 7 1 771:5 HOLDREN.TOM .8;0 :,1,:,: ;-!•:2Amatt., BRIAN oileckiCredIt Memo No: 5.5BAG 8.26 CALCIUM112% HOTWATER 4 4 1 ■1 R flAt CREEK CONCRETE P.OZtiOX 101 SMD0T, WY 83126 ifiVOICE Invoice Number: 97466 Invoice Date: Nov 11, 2010 Page: 00061.2 74. 12.38 41.25 U8_13 2 16.41 974.54 24.74385-0850 FIAT CREEK CONCRETE P.I. Box SMOOT, WY '3126 77174V 4, DEE 6 Bag'Concrete /yard 1/2% PaiCiUM Additive /yani Hot W,ater yd 5/6x10 Anchor Bolts THANKS TONI S ubtota Saes Tax ;1' otal Invoice Amount Payment/Credit Applied 7 7 'R,1000 I .ar 2%i.00 6.08Xe 20.00 CALdUIVI:02%,.';' 2q.00 HOTWATO 50.00 ANCHORS/6),(1Q:: C",6e.dy.'emdlt Memo No: INVOICE invoice Number: 97467 Invoice Date: Nov 16, 2010 Page: 1 00061. 23.50.00 117.50 2407.50 2,1180.00 30.00 40.00 DATED this ©00614 7) The concrete was supplied and furnished under a verbal contract with Call Ready Mix Lumber, Inc., and Tom Holdren with Flat Creek Concrete, wherein Tom Holdren agreed to pay for the concrete received that was placed at the Kibbie residence at the rate set forth on the attached invoices and statement of account. STATE OF WYOMING COUNTY OF LINCOLN SS. By: The foregoing _Statement of Lien was sworn to and subscribed to before me by �Q representing Call Ready Mix Lumber, Inc., this erth 1 -day of 4,-4 2 0/1 WITNESS my hand and official seal. day of fib. Call Ready Mix Lumber, Inc. BethAnn Call, Secretary