2020-02-05_REVISION - M2014070

• Permit No: M2014070
• IBM Index Class Name: REVISION
• Doc Date: 2/5/2020
• Doc Name: Request For Succession Of Operator
• From: Justice Trucking, Inc.
• To: DRMS
• Type & Sequence: SO1
• Email Name: ECS
• Email Name: MAC
• Email Name: GXB
• Email Name: AWA
• Media Type: D
• Archive: No

f.i. 24125 CR 42
T UCX"VGANDS 11.11101..,. LaSalle, CO 80645
970-378-7000
NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF REVENUE
MINE AFFECTED AREA
ACKNOWLEDGED BY:
Structure Owner Representative Name
Date Title
STATE OF Colorado)
) ss
COUNTY OF )
The foregoing was acknowledged before me the_day of 20 by
as of
Notary Public My Commission Expires:
3