2024-10-28_REVISION - M1996076

• Permit No: M1996076
• IBM Index Class Name: Revision
• Doc Date: 10/28/2024
• Doc Name: Request For Succession Of Operator
• From: DRMS
• To: Brett Fontanari Rudolph Fontanari
• Type & Sequence: SO1
• Email Name: ACY
• Email Name: THM
• Email Name: SMS
• Media Type: D
• Archive: No

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