2006-03-14_REVISION - M2002003

• Permit No: M2002003
• IBM Index Class Name: Revision
• Doc Date: 3/14/2006
• Doc Name: Application Form
• From: Joseph L. Dorris
• To: DMG
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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NOTARIZATION OF OPERATOR'S ACKNOWLEDGEINENT
STATE OF ~l~Q )
Cam( ~~ 1 sa.
AUNTY OF
The foregoing instrument was aclmowledged befom me this ~ day of J W ~ . ~~ tty
~ ~~~;~? ~r~~S as l~t~ CD~'.t'Z({'tR of
nand e 5 ~risneur.~c~
OTARY PUBLIC
My C.onanission expires: oc~l o l (ao~ ~
APPROVED: ~ ,~
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State of Colorado - _ ~-•
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Divisi andC3eology - ;,:
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Divisi~ Director
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