2015-01-22_REVISION - M2013007 ‎(4)‎

• Permit No: M2013007
• IBM Index Class Name: REVISION
• Doc Date: 1/22/2015
• Doc Name: Incompleteness SO01
• Type & Sequence: SO1
• Email Name: WHE
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGFD BY:
Structure Owner Name
Date
STATE OF )
) 5S.
COUN1`Y OF )
Titic
The foregoing was acknowledged before me this day of .20—_, by
as of
_ My Commission Expires: _
Kotary Public