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

NMARY FOR STRUCTURE OWNTR
ACKNIO W l .FGED BY:
Structure Owner Name
Date Title
STATE OF }
) ss.
COUNTY OF }
The foregoing was acknowledged before me this—­ day of , 20 , by
as of
My Commission Expires:
Notary Public