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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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w � _ <br /> E t+f BURNCO CORP O FICE0.58 9707 56.752303 637.0900 <br /> !. 301 CENTENNIAL DR. �IN 11111111111111 <br /> MILLIKEN,CO 80543 <br /> CUSTOMER CURInIBR CICDi KANT DATE TRAE TICKR <br /> t UST(M.RRNR.x/ER ARAM)DIlI IWGIN PDUR UAVE RANT <br /> OR(XRrA.lAIY0. CUS10.,0.MMRER 1.O NI.NxIR PREVKNJSMe(P CI?Or AR1 11/0.41 POUR LEAVE IOR ARRIVE RANI <br /> R > • ..._. <br /> 1r OELIVERYADDRCSS"INSTRUCTIONS (PLEASE VERIT ADDRf1,) SUBTOTAL <br /> �I CITYTAX <br /> STATE TAX <br /> WATERADDEDAT CUSTOMER-DRIVER COMMENTS. TOTAL <br /> CUSTOMER'S REQUEST _____ ___.. GRAND <br /> TOTAL <br /> CAUTION <br /> FPRFV110)1US <br /> K DRIVER SLUMP MAP PACE <br /> Freshly mixed concrete may cause burns,blindness and severe skin injures.Avoid contact with <br /> skin. Wash exposed Skin areas promptly with water. For eye exposure,rinse Immediately and <br /> TRUCK TEST RISVITs SLUMP AIR TEMP repeatedly with wotr- 1-4 p.nn,I,t-—f;,of„(+rr,l n•, KEEP OUT OF REACH OF CHILDREN <br /> NOT RESPONSIBLE FOR DELIVERY BEYOND THE CURB LINE. <br /> r r 10324726 II'II I "' III il�i ' I' I JillRECEIPT,RELEASE AND ACKNOWLEDGEMENT <br /> ACJSTOMERTOPROV�OEWASHOVTARfA I _ <br /> UNLOADING TIME IS SIX MINUTES PER CUBIC YARD.TIME IN EXCESS IS SUBJECT TO CHARGE. CUSTOMERS REPRESENTATIVE <br /> f AA I b IL 21. 8.35% 0 <br /> !x l <br /> .IN nz .L�e az <br /> 104.M Pi J�i.l 02 <br /> itdttss <br /> tWErtel't L3r 'ari b,o i1 HL us' A, <br /> I <br /> i <br /> I <br /> I <br /> i <br /> A <br /> , <br /> TM— <br />
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