2024-12-19_REVISION - M2021052

• Permit No: M2021052
• IBM Index Class Name: Revision
• Doc Date: 12/19/2024
• Doc Name Note: payment Received
• Doc Name: Incompleteness Response
• From: Western Slope Materials LLC
• To: DRMS
• Type & Sequence: SO2
• Email Name: TJ1
• Email Name: THM
• Email Name: EL1
• Email Name: SMS
• Media Type: D
• Archive: No

NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF PROJECT TITLE AFFECTED
AREA
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
3