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AUG-21-2815 10: 14A FPOM: T0:17201638386 <br /> 08/21/2015 FRI 16e20 FAX 320 363 8386 C & L axcavatinq y �DD2l043 <br /> RECEIPT AND WAIVER OF MECHANIC'S LIEN RIGHT <br /> 1. This Is a LEGAL INSTRUMENT and must be executed accordingly by officers of corporations and <br /> by partners in co-partnerships <br /> 2, It Is Important that ALL the blanks be completed and the AMOUNT PAID BE SHOWN, <br /> 3. A receipt similar to this or legal waiver of lien rights will be required for all plumbing,heating, <br /> plastering materials,ect. <br /> 4. NO ERASURES OR ALTERATIONS MUST BE MADE <br /> 1) „_As partial payment for labor,skill,and material furnished or to be furnished <br /> 2) _)(_As payment for all labor,skill,and ma enol ftmnished or to be f rni hed <br /> (Except the sum of-SOit "ietentlon) <br /> 3) _As full payment for all labor,skill,and material furnished or to be furn(shed to the following <br /> described real property: (legal description,street address,or project name) <br /> Contract 112014.1412 Centerville MN <br /> And for the value received herby waives all rights acquired by the undersigned to file or record <br /> mechanic's liens against said real property for labor,skill or material furnished to said real <br /> Document 1 property(only for the amount paid in box 1 Is checked,and except far retain age <br /> shown in Box 2 is checked)The undersigned affirms that all material furnished by the <br /> undersigned has been paid for,and all subcontractors employed by the undersigned have been <br /> paid in full <br /> Company Name.- EJ Meyers <br /> Date: 0' t J - I s <br /> Officer/Owner Signature -E ^ <br /> PRINT NAME r r—% 1 GLV <br /> 51 <br />