2016-12-23_REVISION - M1981207

• Permit No: M1981207
• IBM Index Class Name: REVISION
• Doc Date: 12/23/2016
• Doc Name: Request For Succession Of Operator
• From: Western Slope Minerals
• To: DRMS
• Email Name: ACY
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY:
Structure Owne Name C�� J
Date l Title
STATE OF )
ss.
COUNTY OF )
The foregoing wasacknowledged before me this Z-Y day of Navti4� , 20 J4,, by
?n ores as of
My Commission Expires:
Notary Public
TIMOTHY OLK
Notary Public
State of Colorado
Notary ID#20164038408
My Commission Expires 10-06-2020