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2017-08-23_REVISION - M1987092
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2017-08-23_REVISION - M1987092
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Last modified
6/16/2021 2:23:18 PM
Creation date
8/29/2017 8:03:00 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1987092
IBM Index Class Name
REVISION
Doc Date
8/23/2017
Doc Name
Application
From
Jordan Burdick / Blue Mountain Stone
To
DRMS
Type & Sequence
SO2
Email Name
AME
WHE
BJC
Media Type
D
Archive
No
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41-4 <br /> SIGNED, SEALED AND DATED this as day of AVI 06 , ( 01-1 . <br /> 13MoMc1 S1-zc \n <br /> Operator (SEAL) <br /> By: cko' V UiL <br /> Title: OWYlQIr <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF Cth cIo ) <br /> ) ss.: <br /> COUNTY OF iti-d <br /> The fo 1 " U"egoing instrument was acknowledged before me this dot, day of ' � , 1, <br /> by ` Z as X k9 ASA1 of Il 4 ..1 I i 'r .i . <br /> Iwillhilardlidlimay.....mhosimilmo Notary Public (kJ, <br /> I �LORMEDINA tafro..A-73 <br /> 1 Notary PublicI -- State of Colorado I My Commission Expires `� <br /> 1 Notary ID 20164032814 <br /> 4 My Commission Expires Sep 22, 2020 <br /> STA <br /> DEPARTMENT OF NATURAL RESOURCES <br /> MINED LAND RECLAMATION BOARD <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> By: Date Executed: <br /> Division Director <br /> Rev.05/12 <br /> - 13 - <br />
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