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2019-04-02_REVISION - M1974086
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2019-04-02_REVISION - M1974086
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Entry Properties
Last modified
12/27/2024 9:24:27 AM
Creation date
4/2/2019 2:31:12 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1974086
IBM Index Class Name
REVISION
Doc Date
4/2/2019
Doc Name
Structure Agreement
From
AOC
To
DRMS
Type & Sequence
AM4
Email Name
ECS
Media Type
D
Archive
No
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NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF 5 MILE PIT AFFECTED AREA <br /> ACKNOWLEGED BY: <br /> Structure Owner 0 %X (C bUA. Name <br /> Date Title L�T. ts- h b t.l.,L-A <br /> STATE OF J�;L6ZgW ) <br /> ss. <br /> COUNTY O AJ) <br /> 4Thee ing w s ac o ledged before me this /- day of P,�� , 20/y, by <br /> r� r <br /> JL�A, of i <br /> My Commission Expires: a 1 �� <br /> Notary Public <br /> TERESE VIRGINIA LOMBARD <br /> Notary Public <br /> State of Colorado <br /> Notary ID M 20194005945 <br /> My Commission Expires 02-12-2023 <br />
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