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2022-09-28_REVISION - M1998105
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2022-09-28_REVISION - M1998105
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Last modified
9/29/2022 8:57:50 PM
Creation date
9/29/2022 10:32:04 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1998105
IBM Index Class Name
Revision
Doc Date
9/28/2022
Doc Name
Adequacy Review - Preliminary
From
Lewicki & Associates
To
DRMS
Type & Sequence
AM1
Email Name
RDZ
MAC
Media Type
D
Archive
No
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NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF DELTA PAVING GRAVEL <br /> PIT AFFECTED AREA <br /> ACKNOWLEGED BY: <br /> Structure Owner <br /> Date— L - Z Titleell <br /> STATE OF C010f0-d G ) <br /> ss. <br /> COUNTY OF ) <br /> 5� <br /> The foregoing was acknowledged before me this � day of 20,)a, by <br /> Ili i( bIA L, Ck �6-u�✓" as ('t,)ner- of 'the- 'Dfoez.,� Axe �� c Sff c�cfur� <br /> tJ <br /> My Commission Expires: <br /> Notar u 'ic <br /> CYNTHIA J HENSHAW <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20154007886 <br /> MY COMMISSION EXPIRES FEBRUARY 25.2023 <br /> 3 <br />
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