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2015-01-21_REVISION - M2012007
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2015-01-21_REVISION - M2012007
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Entry Properties
Last modified
6/16/2021 2:12:35 PM
Creation date
1/26/2015 4:27:46 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2012007
IBM Index Class Name
REVISION
Doc Date
1/21/2015
Doc Name
Incomplete Application SO01
From
O'Rourke Excavating, Inc.
To
DRMS
Type & Sequence
SO1
Email Name
RCO
GRM
BJC
Media Type
D
Archive
No
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SIGNED, SEALED AND DATED this -- day of X 20JS7 . <br />1l W15 It 4'i s P6 one. <br />Operator (SEAL) <br />Title: pf rs do* P <br />NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br />STATE OF <br />ss.: <br />COUNTY OF �s ) <br />The foregoing instrument was acknowledged before me this 7 day of J ?KVa '901s, , <br />by a Y."V F M. &-f r'F' as Prrsd� of i(sts 4 ► �i �f,u X(--. <br />Notary Public My Commission Expire iA <br />STATE OF COLORADO NOTARY PUB <br />DEPARTMENT OF NATURAL RESOURCES <br />MINED LAND RECLAMATION BOARD r.- STATE OF COLORADO <br />NOTARY ID 10MI716t- <br />DMSION OF RECLAMATION, MINING AND SAFETY iz MY COMMISSION EXPIRE8 �J! <br />By: Date Executed: <br />Division Director <br />Rev. 05/12 <br />-13- <br />018 <br />
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