2018-12-10_REVISION - M1997026

• Permit No: M1997026
• IBM Index Class Name: REVISION
• Doc Date: 12/10/2018
• Doc Name: Application
• From: Oldcastle SW Group
• To: DRMS
• Type & Sequence: SO2
• Email Name: SJM
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF 5 MILE PIT AFFECTED AREA
ACKNOWLEGED BY: f�
Structure Owner Black Hills Energy Name
Date Title SV-. WnVld f-V-
STATE OF
ss.
COUNTY OF6-,#A? 'O,/JP )
The foregoing was acknowledged before me this day of fi73i�v , 20J, by
I)'r R6i ��ifly�i( as of (r�Ck
� Commission Expires:
Y P
N Public
7JOHNKEVIN COMERFORD
OTARY PUBLIC
TE OF COLORADO
RY ID 20184034255
MY COMMISSION EXPIRES 08P MA22