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2021-03-16_REVISION - M1977300 (13)
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2021-03-16_REVISION - M1977300 (13)
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Entry Properties
Last modified
1/10/2025 2:50:54 AM
Creation date
3/17/2021 7:38:43 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977300
IBM Index Class Name
Revision
Doc Date
3/16/2021
Doc Name Note
Pt. 2 of 2
Doc Name
Record of Construction
From
Colorado Legacy Land, LLC
To
DRMS
Type & Sequence
TR28
Email Name
AME
Media Type
D
Archive
No
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i <br /> DDISPATCH 970.587930E 1 303.6370900 <br /> CORP OFFICE 970 356s'7513 <br /> 301 CENTENNIAL[}R <br /> /3 MILLIKEN,CO 80543 <br /> C1nTnA{� aKR>1:1111"'t coo RANI MTF ibl[ TK 11 t <br /> ctatorFRt ARRIS[1V ,RE►OUR LEAVF A.ANT <br /> ORD(R NUMK 1 CLW JOB 141 MKII ►O NAME.~ rtlNONfE'p '-"AA. FRRSFt POUR LEAVE PS ARRIVE PLANT <br /> i <br /> I <br /> DEUvERY ADDRESS INSTRUCTIONS (PLEASE VERIFY ADDRESS) SUBTOTAL <br /> CITY TAX <br /> STATE TAX <br /> WATER ADDED AT CUSTOMER DRIVERCOMMENTS TOTAL <br /> CUSTOMER'S REQUEST __ GRAND <br /> TOTAL <br /> TRUCK DRIVER SLUMP MAP PAGE ado <br /> - - O <br /> F; xed concrete may cause burns,blindness J severe skin nturieS. Avcd contact with <br /> :sh exposed skin oreos promptly with water. Far eye expo<we, rise m+.r rd,ntrfy n"d <br /> PREVIOUSTRUCK TEST RESULTS SLUMP AIR TEMP <br /> r,catedly with water.Seel n.KEEP OUT <br /> NOT RESPONSIBLE FOR DELIVERY BEYOND THE CURB LINE. <br /> 10318925 I I'I I I I I I 'I I' I I 'I I"I RECEIPT,RELEASE AND ACKNOWLEDGEMENT <br /> CUSTOMERTO PROVIDE WASHOUT AREA. ,r' -- �"✓"�--�'` <br /> UNLOADING TIME IS SIX MINUTES PER CUBIC YARD.TIME IN EXCESS IS SUBJECT TO CHARGE "� <br /> CUSTOMER'S REPRESENTATIVE <br /> 1�QtI tt5i_ <br /> 1_08C i ipr,tIY'TS@ <br /> I M�t�rtal lkscm'! Rtqusred tE�t. <br /> f mil CENI 5C8.+l 1 3168.0 Itr795. <br /> 9.t0 1 b <br /> k> SIX 1 s2.$ l b 792.0 lb 6 1 b <br /> AIM CRUM #57-67 im- lb 10616 ibL`N Ike RTE 9W ifw Ih IbAIR FNTR€?tF T „so a:�.2A o: c.?7.2$ rstt .Rf+ a. <br /> ATEs <br /> IfiVDiiION ,TFIBIII =;, 3x 4 <br /> -ktus _ IW Ache: <br /> L.am Totait 2a lb vatkP^.tm t 4t <br /> 111ulp i.m In Hattr rig >-- u <br />
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