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AGREEMENT AND PROOF OF DELIVERY/FILING FOR M2020-062
<br /> Signed Structure Agreement, Rio Grande County Receipt, Rio Grande County Clerk& Recorder
<br /> Road& Bridge Department (Public Review Copy)
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<br /> NOTN,rM STRUCTURE OWNER
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<br /> �.. .. « .-,•. d:<. RECEIPTNERFICATION OF RECEIPT(To be carc'erted and sunned @%e-rnaJM
<br /> back to WASTEUNE.aa532CamsItCa11 as soon as remrved and"font0 COMPleae.:
<br /> tamr..R.e I'Ves, - DATE OF RECEIPT ;-III-s T
<br /> :�..- PRINTED NAME OF PERSON R4CEAONG THIS
<br /> SIGNATURE ;: i nF_ )
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<br /> v`GRANDE
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<br /> Copy)
<br /> Receipt, Rio Grande County BOCC Notice Receipt, Rio Grande County Conservation District
<br /> WASTBLIN£INC. IM WAST£LINE INC,
<br /> P.O.Box 3E71 Rated CEY.SO 577MU71 PO Ben as Cato,CA s13214M P 0 Sax 3471 Read Off,SD Sr7%3a71 PO am M Ocem,0081321-0=
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<br /> _..— —
<br /> 03 March 2021 - 15 F.W—y 2021
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<br /> 61132 0048 W County Hoed 10 N
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<br /> VIA Emae a
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<br /> 3. Map dwean kclm-d aoPaae I oprabon(Eruu A of DRYS W~package) E—se
<br /> a. MAP«burn wo msee m ng end reciameben(C~E of DAMS appNcrlcn package', 1 Nobce III,R.Gee•1tle f:u►waten DaUG
<br /> 5. Copy of Pudic Nance puswe r Ir,mn,(on CR-15)
<br /> 2 Copy of DAMS r PP&msI on IVM for Leda~Darnel
<br /> ReaPecaupy, 3. MAP Mmex,g me~d pnpoeed p(wramn(E.helt A or DRMS epplledkn I—kaas)
<br /> a MV b,p dm-g
<br /> 5 ofR,fcoP ed. atnmamn(Extxbd E d ARMS applk:sUon pXAmgal
<br /> (on CR-15)
<br /> NaM.A Barton GE,PE,OEE,C_Qvol1er. RospodNay.
<br /> NWSTEUNE INC.(Pralapl Enaew«;
<br /> On aeNall a O AWdw E. &na
<br /> Ndhsn A.esnon.CE,PE.OEE.CgrrpNlMr
<br /> RECEIPT/VERIFICATION OF RECEIPT(To be Cornpleted and sunned and e+na4ee WASTEt INE.01C.lRgael E)rplla«>
<br /> back to W TELINE.B8iz3 nmad corn as soon as received and v rfad compete.) tan IWelf d O'Rouka E.aa.•don
<br /> DATE OF RECEP 3- 7-�U
<br /> PRINTED NAME PERSON RE -ING THIS _ ��v -' RECEIPTNERIFICATION OF RECEIPT(To be completed and sunned and o-maned
<br /> !, I / .-- back to WAST£LINE 8/532pWWI pm as soon as recervea and verified eornowte.)
<br /> SIGNATURE:'1Y�!'i(1 �irt's+r-- (SEAL IF USED)
<br /> ,y�f-- DATE OF RECEIPT 4•
<br /> 1!r— PRINTtUNAME CEIYINOTHIS- Syn_niam 3 n
<br /> SIGNATURE: ,,.. 8EAt1F USED)
<br />
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