2018-01-02_REVISION - M1984094 ‎(3)‎

• Permit No: M1984094
• IBM Index Class Name: REVISION
• Doc Date: 1/2/2018
• Doc Name: Application
• From: Playfair
• To: DRMS
• Type & Sequence: SO4
• Email Name: MAC
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY:
Structure Owner�SaG/? -We.9�o oo* 1?erell l�����d/71 ,g�a�G/1 i
Date ��/S//7 Title ,$��i e a S
STATE OF Co to
ss.
COUNTY OF �f s o )
The foregoing was acknowledged before me this�tday of _ , 20/ by
Iv,/ 4 as/:��, ,B/�f� S�d� ofLo ell eeve Wl-�a
t YK A_ n Ac.hcc My Commission Expires: 1j H aa_:�,
Notary Public
KIM A.KETCHAM
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19964019423
MY Co1V9MMM EXIRES NOVE W 7 20M