PERMFILE70145

• Permit No: M1994097
• IBM Index Class Name: Permit File
• Doc Date: 9/6/1994
• Doc Name: APPLICTION FORM
• Media Type: D
• Archive: No

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4. I understand that statements in the application are being made under penalty
of perjury and that false statements made herein are punishable as a Class 1
misdemeanor pursuant to Section 18-8-503, C.R.S.
Signed and dated this ~_ day of ~~ ~ .
Aoolicant/OoeratoY
~~\ i
If Corporation Attest (Seal)
By:
Corporate Secretary or Equivalent
Town/City/County Clerk
The foregoing instrument was acknowledged befo(r~e me this ~ day of $~~.em6er /S~(
by Ag2or,1 P. ~. ~ ion as r;enera! j'Ar~-i-~e/2 of M!~ ~iOn AariGU./ ra.Q,
~i,ues-l-ir,en~!-s Lid
n ~-~, d e r~~)
No ary Public ~ (/
My Commission Expires: ~ ~- 9S
(04{92) 2823E
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State of (..'o/oro~olo >
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County of ~l-~pn'{1^"a5e )