2017-03-29_REVISION - M1977559

• Permit No: M1977559
• IBM Index Class Name: REVISION
• Doc Date: 3/29/2017
• Doc Name: Application
• From: South Forty Recreation, LLC
• To: DRMS
• Type & Sequence: SO1
• Email Name: TC1
• Email Name: WHE
• Email Name: BJC
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY: ` ,Structure Owner Gl�/�/Z Name �ltl�t �A21z..
Date ZDlh Title
STATE OF
COUNTY OF }ss.
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T e foregoing was acknowledged before me this day of , 20��by
of
otary P blic y Commission Expires:
�
SHARON FORSTER RUSSELL
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19904004390
MY COMMISSION EXPIRES MARCH 26,2018