2022-07-13_REVISION - M2005066 ‎(2)‎

• Permit No: M2005066
• IBM Index Class Name: Revision
• Doc Date: 7/13/2022
• Doc Name: Structure Agreement
• From: Oldcastle Material Southwest Group
• To: DRMS
• Type & Sequence: SO2
• Email Name: ECS
• Email Name: MAC
• Email Name: SMS
• Email Name: AWA
• Media Type: D
• Archive: No

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NOTARY FOR STRUCTURE OWNER WITHIN 200 FT of 5 MILE PIT AFFECTED AREA
ACKNOWLEDGED BY: (Signature of Officer)
Structure Owner: Brighton Ditch Company Name:
Date: Title:
STATE OF )
)ss.
COUNTY OF )
The foregoing was acknowledged before me this day of , 2021, by
as of
My Commission Expires:
Notary Public