2019-10-17_REVISION - M1978208

• Permit No: M1978208
• IBM Index Class Name: REVISION
• Doc Date: 10/17/2019
• Doc Name: Request for Conversion
• From: Elk Creek Diversified Services
• To: DRMS
• Email Name: ECS
• Media Type: D
• Archive: No

i
CA'SH ONLY IF A L I.Checht&ck 11 Sf(AJAIfY FF A IU AFS I IS TED ON BACK INDICATE NO TAMP E RING OR COPYING
Elk Creek Sand&Gravel LLC. Evergreen National Bank 24789
wait., Shaffers Crossing Quarry EVERGREEN,COLORADO$0437 3
PO BOX 416 (303)8742700
Conifer,CO 80433 82-386/1070
' [phone]
I 7 ?FI
Y
PAY TO THE $ ( G a
ORDER OF In 0 �1 8
'S OE R
rfri YY
L
v
3 037--L.-a� IS n■
Elk Creek Sand&Gravel,LLC 24789
t