2015-02-27_GENERAL DOCUMENTS - M2014070

• Permit No: M2014070
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 2/27/2015
• Doc Name: Damage Waiver For Exhibit S
• From: GoodMiller #2 Pit
• To: DRMS
• Section_Exhibit Name: Exhibit S
• Email Name: ECS
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF REVENUE MINE AFFECTED
AREA
ACKNOWLEGED BY:
Structure Owner MU rtlk -% ( y, 4 I �- %%� Name �' e C n T• S U n A e }'
Date 2 5 Title Mc, �u!\ ,er c f roy;oeer
STATE OF i,,C, )
) ss.
COUNTY OF ` )
The foregoing was acknowledged before me thisj_2�Dday of , 206, by
C�YI T &M &as rno o11 101;A
iQ/—TqA ANGELA LARSON
My Commission Expires: NOTARY PUBLIC
Notary Ablic ADO
NOTARY ID 20044031101
My commission Expires September 1, 2016