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2019-05-03_REVISION - M2002120
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2019-05-03_REVISION - M2002120
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Entry Properties
Last modified
6/15/2021 2:39:00 PM
Creation date
5/3/2019 3:10:24 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2002120
IBM Index Class Name
Revision
Doc Date
5/3/2019
Doc Name
Request For Amendment To Permit
From
Bestway Concrete & Aggregates
To
DRMS
Type & Sequence
AM1
Email Name
ECS
MAC
Media Type
D
Archive
No
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INDIVIDUAL ACKNOWLEDGMENT <br /> 0.1etAO*ais*aloe toe b 0071 WOO b lci 0.01ce tal 0 fC4ot7b e9 not 044:0Pv2V. ,1M00sr4,:#00,1:10 0,04**It**O.sat�'9�.: <br /> StateiCommonwealth of C�/4y cerd' <br /> , e County of !�f% ss <br /> On this the . day of f/ 7C! , before me, <br /> Day Month Year <br /> -✓ L <br /> 7,2/://:7' <br /> , ' ---------_ the undersigned Notary Public. <br /> Name of M ory Public <br /> personally appeared _.__6 fnt' <br /> Name(s)of Signer(s) <br /> Y,Lpersonally known to me-OR- <br /> proved to me on the basis of satisfactory evidence <br /> to be the person(s) whose name(s) isiare subscribed <br /> to the within instrument, and acknowledged to me <br /> that he/she/they executed the same for the purposes <br /> therein stated <br /> WITNESS my hand and official seal <br /> MaDAL vE �n,iaa 1 � /__ <br /> `Jotari P.,D!•=: Signature of N. • Public <br /> a e 3i Co 3r3n:• <br /> !7 tt 2'J0a3 378.4 <br /> ' m1' ss.L`.. E<o 'es'vf?'.. .16 I <br /> Any Other Required Information <br /> Place Notary Seal/Stamp Above (Printed Name of Notary, Expiration Date, etc) <br /> OPTIONAL <br /> 3 <br /> This section is required for notarizations performed in Arizona but is optional in other states <br /> Completing this information can deter alteratron of the document or fraudulent reattachment <br /> of this form to an unintended document. <br /> Description of Attached Document <br /> Title or Type of Document <br /> Document Date- _-_ Number of Pages <br /> Signer(s)Other Than Named Above' <br /> yr ren: p. .n t <. . ,. .. <br /> 2017 National Notary Association <br />
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