2022-09-26_PERMIT FILE - M2022042 ‎(17)‎

• Permit No: M2022042
• IBM Index Class Name: Permit File
• Doc Date: 9/26/2022
• Doc Name Note: Exhibit S - Permanent Man-Made Structures
• Doc Name: Application
• From: Julie M. Mikulas -Martin Marietta Materials, Inc
• To: DRMS
• Email Name: PSH
• Email Name: JLE
• Media Type: D
• Archive: No

3
NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY: _______________________________________________________
Structure Owner: ___________________________ Name: ____________________________
Date: _____________________________________ Title: _____________________________
STATE OF ______________)
) ss.
COUNTY OF____________)
The foregoing was acknowledged before me this____ day of _____________, 20___, by
______________________ as _____________________ of __________________________.
______________________________ My Commission Expires: ________________________
Notary Public