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REV13636
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REV13636
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Entry Properties
Last modified
8/25/2016 1:24:45 AM
Creation date
11/21/2007 10:44:10 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1997064
IBM Index Class Name
Revision
Doc Date
9/14/1998
Doc Name
TRANSFER OF PERMIT & SUCCESSION OF OPERATORS APPLICATION FORM
Type & Sequence
SO1
Media Type
D
Archive
No
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<br /> <br />-s- <br />PERMITTEE <br />~I L LI Pr+'~ ~4 I,ES~ A ~- <br />Name of Permittee <br />Signature of Officer <br />SUCCESSOR OPERATOR <br />/it//L.~~7'1'/ H L~~~ 17i4~ L <br />Name o/f Successor <br />Signature of Officer <br />~~iti~2 _ Qtr ©w~v~~. <br />Title of Officer Title of Officer <br />NOTARY FOR PERMITTEE <br />State of ~ ~0 r a ~ ) <br />) <br />County of J~2yl /.~,r ) <br />The foregoing instrument was acknowledged before me this 1`L day of SP~ ~"f ribe~, ~ by <br />~~ l~, a wt /1 ~ Iles fa ( as I~ar~- owe ~r of <br />~LG <br />W of C /~~' C <br />Notary Public IJ~CGC/1'( T~~c4-~ <br />My Commission Expires /Yjacc~r o?~ ~9/c'S <br />NOTARY FOR SUCCESSOR <br />State of ~~~~/a~ ) <br />Countyof~e>7~{/ ) <br />The foregoing instrument was acknowledged before me this ~`' _ day of .SC~f~wt ~i / , ~ by <br />~,t~,c:n1 ra I/25+~ as ~a~-)' O~rII~/' of <br />tn~?Sf~lrh i~ufr~-rn~, ~Hc <br />Notary Public „~LfI( / -rOC:t4^-~ <br />My Commission Expires /~2Uli ~5~99~ <br />
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