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Laserfiche Index Form <br />*Please fill out/add this form to the top of your document(s), underneath the barcoded cover sheet. <br />Permit Number I'll 061,q 9 5 i <br />Document Date fl -7/c219/6 <br />Index Class Type <br />From PA5 <br />To 57z2-CL.L-C, <br />Minerals Contact(s) <br />Document Name /41,0" 51-0-S <br />Revision Type(?) <br />Check Box if confidential <br />