2024-08-13_REVISION - M1999050 ‎(3)‎

• Permit No: M1999050
• IBM Index Class Name: Revision
• Doc Date: 8/13/2024
• Doc Name: Adequacy Review Response
• From: Blue Earth Solutions
• To: DRMS
• Type & Sequence: AM1
• Email Name: JR2
• Email Name: AME
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY:
Structure Owner CenturyLink(Lumen) Signature
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