2014-10-10_REVISION - M1979097

• Permit No: M1979097
• IBM Index Class Name: Revision
• Doc Date: 10/10/2014
• Doc Name: Structure Agreement
• From: City of Fort Collins
• To: DRMS
• Type & Sequence: SO5
• Media Type: D
• Archive: No

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NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY: 11,,
Structure Owner Name ]�bj,7
Date till 5f , 02 /�1 Title )Dres(1,f
STATE OF d' )
)ss.
COUNTY OF I in l Y )
Ie foregoing was acknowledge4,1pefore me thisday of ,20 ,by
C;? P 4 i! as �.' ' e of z 112m"96,4t—
My Commission Expires:
otary Public
•MELISM H.BUICK
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20054024373
My Commission Expves,A!4I C,20j7