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RECEIPT AND WAIVER OF MECHANICS' LIEN RIGHTS <br /> N.B. It is important that the following directions be closely followed as otherwise the receipt WILL <br /> NOT BE ACCEPTED. <br /> 1. This is a LEGAL INSTRUMENT and must be executed accordingly by officers of corporations <br /> and by partners of co-partnerships. <br /> 2. It is important that ALL the blanks be completed and that the AMOUNT PAID BE SHOWN. <br /> 3. If payment is not in full to date, so state. SHOW UNPAID BALANCE, and strike out last three <br /> lines. <br /> 4. A receipt similar to this or legal waiver of lien rights will be required for all plumbing, heating <br /> and plastering material,etc. <br /> S. NO ERASURES OR ALTERATIONS MUST BE MADE. <br /> November 9 1�2 <br /> (DATE) ' <br /> The undersigned acknowledges having received payment of Three thousand three hundred fifty five <br /> dollars and eighty five/100--------------------- DOLLARS( .3355 . 85 <br /> (Amount Paid) <br /> from City of St. Anthony in full payment of <br /> (Name of Payor) <br /> all CONCRETE MATERIALS delivered thru June 23 , 1992 <br /> (Kind of Material or Labor) <br /> by the undersigned delivered or furnished to(or performed at) 2 512 Kenzie Terrace <br /> (Street Address or Legal Description) <br /> and for value received hereby waives all rights which may have been acquired by the undersigned to file mechanics'liens <br /> against said premises for labor, skill or material furnished to said premises prior to the date hereof. This lien waiver subject <br /> to check received being honored by bank. <br /> MODEL STONE CO. <br /> PLUMBING, HEATING and PLASTERING By <br /> contractors must sign statement on reverse hereof <br /> (TITLE) <br /> Address Mpls., MN 55419 861-6041 <br />