HomeMy WebLinkAbout904229 CLAIM OF LIEN RECEIVED
GIVEN IN ACCORDANCE WITH W.S. S[~,'~I~'~'~92q)I3'~l-Y CLERK
90[,229 l: i6
Etna 83I{ 1J;,CkwCyo°rmS'inga~o; ~;ne~;°~oD~v~/~rn~'hn~;eL;Ed~;{:,' ;,::v~[~S 89,
accordance with W.S. section 29-2-107, to Thomas VanZam and Julie Johnston, owners, whose
address is P.O. Box 1871, Jackson, Wyoming 83001, LIENEES, WITNESSETH:
That the LIENOR, has a claim against the real property and/or materials, services, and
improvements on that certain Parcel/Lot located on the herein-alicr described property, for
improvement, services, materials and/or labor furnished on said parcel and land, in the amount of
$4,110.10, to-wit:
SE1 / 4NWl / 4 of Section 2, T35N R119 W, 6t~ PM Rock Farm Rd, Etna, WY
as recorded and platted in the Office of the Lincoln County Clerk, in Kemmerer,
Wyoming.
Together with all improvements and appurtenances thereon.
That the above stated amount is still owed to Jack Corsi a/k/a Precision Dirt Work, by
Thomas VanZant and Julie Johnston in accord with contract and agreement. That Precision Dirt
Work provided equipment, materials, services, and labor on said land for the above owners. An
itemized list of work performed is attached. (Attachment #1).
That the date when work was last performed by Jack Corsi a/k/a Precision Dirt Work on
the above described property was July 2, 2004.
That the amount left owing to Jack Corsi, LIENOR, b~r Thomas VanZant and Julie
Johnston, LIENEES, is $4,110.10.
STATE OF WYOMING
COUNTY OF LINCOLN
ACKNOWLEDGMENT
WITNESS, the hand of said Lienor, thi~,~~,..
Jac~Corsi
)
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The foregoing instrument was acknowledged before mc by ,lack Corsi, this
October, 2004.
WITNESS my hand and official seal.
Notary Public
day of
My commissio~n expires:
TAMARA HORSLEY - NOTARY PUBL!C
County of ~ State of
Lincoln Wyoming
~.?~ Commission Expires September .... 8, 20~.:_--. _-.- % _,_--_.__?~.
PRECISION DIRTWORK
Jack Co~'si
111314 N. US 89
Ema, WY 83118
307-883-2203
ORDER NUMB£R DATE
BUYEFI:
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