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T <br />I'OR\4 G <br />� �; � <br />� � • CI'i P OF �V�R�TT <br />,�� . <br />Snc}:on:.cl: �c::�; y, :',-a:;'.::;7gt�:� <br />UNSAF� 13UILDiNGS RI.FLl:ENC� NO. 71-7-7'3 <br />STA1'I� OI� \YASI]ING'I'ON ) s� <br />COUNTY O]' S\`OIIO,�-IT' :I ) Al� rII���VIT O7' S�RVICI: <br />The undcrsiyned, bcing first citily svorn on oath� dcposes and says: <br />1, That in and during a11 times hercin mentioned, aCfia�it �vzs and no�v <br />is ovcr ihc age of twenty-one ycars� a citizen of the United Siates, a residc�it <br />oi lhc State of �vashinglw� and compeLenC to Uc a�vitness hcrein, <br />2. That affiant served a full, true, correct duplicate original copy <br />of tl�e follo�vi�tg describeci docuinent; (Giross out inapplicable notices) <br />(a) P;OTICE OI' UNSAl'E ]3UILDING(S) <br />( BY- z z z 3 Z�b7_'Zd �'z ¢?� 7.��� P_�Y �'P %�� z��Z � Y�'k� � L�i� <br />@3ZFd��z������3ZZ�sfi�gZR2Q�k��2�?�zkX�� <br />.i�Z��3��7_r3Z <br />( ��ZZZZ7I�ZZTd£ZEl_03�Z¢d3ZYZQdZYId�1�ddZp�iZ@�2k� <br />A copy of �vhich is attaclied lierefo and by t17is reference <br />madc a part hcrcin as though set forth in fu11 hcrcin <br />upon cach oi the follo�ving last ]:no�vn o�vncr(s) of <br />record of thc Uuilding(s), or strucCurc(s), or portion(s) <br />thcreof dcscribed in said document by the. rnanner set <br />forLh hcrcinaiter: <br />(a) PERSONAL SERVICE <br />By delivering and leaving said copy with said owncr(s) <br />at thc place and timc set forth hereinbclow: <br />Owncr Namc Address Scrved Datc Served <br />