2017-03-10_REVISION - M2014042

• Permit No: M2014042
• IBM Index Class Name: REVISION
• Doc Date: 3/10/2017
• Doc Name: Application
• From: Russell Painter
• To: DRMS
• Type & Sequence: CN1
• Email Name: ERR
• Email Name: WHE
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY:
Structure Owner F(U rw- S erV;Lc Name `)OShj a S. yoo rho s
Date 2, -2`i - 2k 17 Title 1,u n j c-r
STATE OF C 0
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COUNTY OF -�CIIe./ )
The foregoing was acknowledged before me this Zy1-4day of �=�b.�� , 2C /7,by
as ,d.".c � �� of
p My Commission Expires:
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F
IFER BUNCH
RY PUBLIC
F COLORADO
D 20124021956
on Expires 04-11-2020