2015-03-09_REVISION - M1994114

• Permit No: M1994114
• IBM Index Class Name: REVISION
• Doc Date: 3/9/2015
• Doc Name: Response To Preliminary Adequacy Review CN01
• From: Azurite, Inc
• To: DRMS
• Type & Sequence: CN1
• Email Name: TOD
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY:
o
Structure Owner e
Date % •— �� � f ,S Title
STATE OF
) ss.
COUNTY OF
The foregoing was acknowledged before me this `� day of . c r , 20 % 5 ,�by /
G i S G as A1�4,eA C 0a55
�� G � ,%
My Commission Expires: `%
Notary Public
LORI LOUISE SISTODEAU
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20144020415
MY COMMISSION EXPIRES MAY 20, 2018