2015-02-09_PERMIT FILE - M2014070

• Permit No: M2014070
• IBM Index Class Name: PERMIT FILE
• Doc Date: 2/9/2015
• Doc Name: Response to Adequacy Letter
• From: Greg Lewicki and Associates, PLLC
• To: DRMS
• Email Name: ECS
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF REVENUE MINE AFFECTED
ARE A
ACKNOWLEGED BY:
Structure Owner
Date Title
STATE OF )
) ss.
COUNTY OF )
Name
The foregoing was acknowledged before me this day of .20___., by
as of
My Commission Expires:
Notary Public