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PERMFILE45910
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PERMFILE45910
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Entry Properties
Last modified
8/24/2016 10:48:13 PM
Creation date
11/20/2007 12:32:05 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980189
IBM Index Class Name
Permit File
Doc Date
12/21/1978
Doc Name
LIMITED IMPACT 110 & SPECIAL 10 DAY 111 PERMIT APPLICATION FORM
Media Type
D
Archive
No
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~~~.q ~7CH/B/T <br />Exlf/Bl~ .8 <br />. ,FxH/BiT E <br />'ExHiB1T F <br />~xH~aiT ~ <br />Sel <br />Add. <br />•-- <br />~i~~ `? 1 1';i~ <br />~~,,,~~rv SECTION <br />:,d. ~~at. of Natural Resources <br />PURCHA$~E~ ORDER <br />Gravel ~( <br />Water <br />Soil C] <br />Other Q <br />NUMBER ~_ <br />E1 Paso County <br />DEPARTMENT OF PUBLIC WC3RK5 <br />3170 Century, Colo. Spgs., Colo. 80907 <br />9~~ <br />Refer to the above number or <br />provide a cony of this order <br />with any claim you may find <br />necessary to file. <br />• <br />Check One <br />I declare that Z am o•+mer of the real proaerty wherein <br />exists and is located in Township / S (s), Range O~ w, <br />Section ~ Quarter .S~l/U The Department of <br />Public Works may purchase from me, in the quantity <br />estimated bel w, during the period - - to include /~~~ <br />-/~ 7~ subject to the following p'~Provisio~'.c~~~ <br />(If none this will be so noted hereon3. /G ~i <br />Unit of <br />Measure <br />~~~y i <br />Cost <br />Per Unit <br />~~ ~~ <br />/off` <br />Payments to be made monthly by Warrants issued by E1 Paso County based upon <br />`_he number of units purchased during prior month. <br />~~ <br />Signatufi of~Seller) <br />irchase Order Acouired by ~ ~/.lll <br />Signatur <br />~ r~ 7th <br />' itle <br />(Purchasing Agent) <br />_. --, ! ~ i <br />'chase Order Approved by ~~ ~ ,~ ~-_~ / 1 . C..~ ~ ~~~ <br />Max L. Rothschild, P.E. <br />Director of Public works/County Engineer <br />rz~i~ <br />Approx. No. <br />of Units <br />
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