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2019-10-11_REVISION - M1977376
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2019-10-11_REVISION - M1977376
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Entry Properties
Last modified
1/6/2025 5:29:56 AM
Creation date
10/11/2019 2:30:34 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977376
IBM Index Class Name
Revision
Doc Date
10/11/2019
Doc Name
Request For Succession Of Operator
From
Daniel Tezak
To
DRMS
Type & Sequence
SO4
Email Name
TC1
GXB
MAC
Media Type
D
Archive
No
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Bond No. 107138075 <br /> 6 - <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF U)) (G6 d ) <br /> )ss. <br /> COUNTY OF 1p�exy-)ca'-,C ) <br /> The foregoing instrument was acknowledged before me this -1 ti-� _day of 0C)-QtEe '1� <br /> b A as fybftwc^ Olce►-Ibu . of Cbyc,, <br /> RHONDA K LEWIS <br /> Notary Public k <br /> State of Colorado <br /> Notary ID 19954007903 NOTARY PUBLI <br /> My Commission Expires Feb 1, 2020 <br /> My Commission expires: 1 <br /> APPROVED: <br /> State of Colorado <br /> Mined Land Reclamation Board <br /> Division of Reclamation,Mining and Safety <br /> By: Date: <br /> Division Director <br /> M:bninlsharelhondformslCorporatc Surety REVISED 10/16/07 <br />
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