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PERMFILE61002
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PERMFILE61002
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Entry Properties
Last modified
8/24/2016 11:07:43 PM
Creation date
11/20/2007 6:58:28 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1991133
IBM Index Class Name
Permit File
Doc Name
REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
Media Type
D
Archive
No
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<br />-5- <br /> <br />4. I understand that statements in the application are being made under penalty <br />of perjury and that false statements made herein are punishable as a Class 1 <br />misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this 19th day of MaT <br />~/ ~ ~ <br />'/_ (/z- <br />orney for <br />Applicant/Operator Demetrio and Olive Valdez <br />By: _ <br />Title: <br />If Corporation Attest (Seal) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of 1id)orAcQo ) <br />/~ > ss. <br />County of ~on~e~ps ) <br />The foregoing ins rument was acknowled ed before me this (L~ day of ~1 , i~ <br />by~!!Q- ~ f2 - ~~/.t.~.~.. as of / O ~ ~ ~ <br />~/~cCP~ <br />`~~.~ <br />-- ~ Notary Publ i <br />_ - = My Commission Expires <br />._ __ r - <br />~..~~ ~, <br />By: <br />(08/91) 2823E <br />
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