2015-12-28_REVISION - M1982098

• Permit No: M1982098
• IBM Index Class Name: Revision
• Doc Date: 12/28/2015
• Doc Name: Application Adequacy Responses CN01
• From: Kit Carson County A/P Clerk & Gravel Pit Associate - Peggy Dunlap
• To: DRMS
• Type & Sequence: CN1
• Email Name: ERR
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED )) // �
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Structure Owner / r i S 1 T}, /, j;„C 7-,:a 6 f Name
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Date
Title 6eLA
STATE OF ce,10f'0F )
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COUNTY OF %rt. Oars,...)
T e foreg ing was acknowledged before me this / day of , 2O/ by
A-(411-1.1-3as (12-4())2,0) of -tom e�!t��
My Commission Expires:
PAULA S. WEEKS
R7O1.J P” PUBLIC
ST.
NGI,A.r,r ,3 i, '4027129
MY COMMHSI`)N EXPIRES AUG. 20, 2016