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12 I3-2OOB O2:23PM FROM-T A RCN€FSKY & SONS <br />of' iir 7843 T-326 P.O02/062 F-873 <br />RECEIPT AND WAIVER OF MECHANICS' LIEN RIGHTS <br />Dated December 3, 2009 <br />The undersigned hereby acknowledges receipt of the sum of $31,701.84 <br />CHECK ONLY ONE <br />as partial payment for labor, skill and material furnished <br />as payment for all labor, skill and material furnished or to be furnished <br />X as full and final payment for all tabor, skill and material furnished or to be <br />furnished to the following real property <br />Gem Lake-Scheueman Road Improvements <br />And receivedhereby waives d11 rights acquired by the undersigned to <br />file or record mechanic's liens against said real property for labor, skill or material <br />furnished to said real property (only for the amount paid if Box 1 is check and <br />except for retainage shown if Box 2 is checked). The undersigned affirms that all <br />material furnished by the undersigned have been paid in full except: <br />C W Houle Inc <br />By�Ott--LJ3 <br />Title. <br />1300 W County Road I <br />Shoreview, MN 55126 <br />Please mail to: T. A. Schifsky & Sons, Inc. <br />2370 E Highway 36 <br />No. ,St. Paul, MN 55109 <br />Fax #651-777-7843 <br />