My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
REV03951
DRMS
>
Back File Migration
>
Revision
>
REV03951
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/25/2016 1:01:57 AM
Creation date
11/21/2007 9:13:34 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1986076
IBM Index Class Name
Revision
Doc Date
7/3/2002
Doc Name
TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
From
DGMC
To
DMG
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
9
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
-3- <br />PERMITTEE <br />Rol? er{- w , N•i~~ <br />~~~ - <br />Name of Permittee <br />By ~ ~ ~~ <br />Signature of Officer <br />/12i4~J~Q-~r,y® 1~~4Rt-,y~rZ <br />Title of Permittee <br />NOTARY FOR PERMITTEE <br />State of i ,(,[~~~~.{~ ) <br />~- ) <br />County ofa.~ (/,/j/ytJ ) <br />SUCCESSOR OPERATOR <br />J~//I~ l~n~~~OcrnG <br />Name of Successor <br />By l/~YL ~/'~"o"~' <br />ignature of Officer <br />aww~2 <br />Title of Successor 0 erator <br /> <br />The foregoing instrument was acknowledged before me this eday <br />Notary Public , <br />My Commission E fires ~ '3 ~~ <br />NOTARY FOR SUCCESSOR <br />State of ~ic~CC.C.(7 ) <br />C' -~ > <br />County o1~/YI~JI,Q~9i~Q ~ > <br />The foregoing instrument was acknowledged before me this ~ day <br />of .l~a/h.P_, ~Q2,• by J"irn /3en d~~ <br />Notary Publ i c ,LfiQQ~~(• dL~~,//c~~~ <br />My Commission Expires ~ ~~[,~ <br />
The URL can be used to link to this page
Your browser does not support the video tag.