2005-01-04_REVISION - M1999120 ‎(2)‎

• Permit No: M1999120
• IBM Index Class Name: Revision
• Doc Date: 1/4/2005
• Doc Name: Response to Adequacy Review Ltr
• From: Banks and Gesso LLC
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

O1/0~/06. 14:,x5 FA% ~Oa2891J48
L G EVERIST
SET-RACK AGREEMENT

The notarized signatures of the Structure Owner Representative and the Applicant
Representative confirm the Agreement between the parties and the repair/compensation
obligation of the Applicant as stated above.
Agreed by the Applicarn:
of
and Title (please
Slate of Colorado )
ss
County of )
L. G. E1/ERIST, INC.
for L. G. Everist, Inc.
The foregoing instrument was acknowledged before me i
. 2004, 6y the signatory Represenfative above
Notary Publ '~- My
Agreed by the Structure Owner.
WELD COt1NT1
Signature of Representative for Weld County
~~~~ X47
Pate
rIy Caes~lan E:q~s Jn 2L 210!
Date
Name and Tale (please print)
State of Colorado )
ss
County of )
The foregoing instrument was acknowledged before me on this day of
2004, by the signatory Representative above. Witness my hand and official seal,
Notary Public:
My Commission expires:
LMIFL•200R-WeIdCo-09120d.doe