2015-07-24_REVISION - M2004031

• Permit No: M2004031
• IBM Index Class Name: REVISION
• Doc Date: 7/24/2015
• Doc Name: Denial TR05
• From: DRMS
• To: Aggregate Industries - WCR, Inc.
• Type & Sequence: TR5
• Email Name: TOD
• Email Name: WHE
• Media Type: D
• Archive: No

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