2001-03-20_REVISION - M1992069 ‎(2)‎

• Permit No: M1992069
• IBM Index Class Name: Revision
• Doc Date: 3/20/2001
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO2
• Media Type: D
• Archive: No

_;.
PERMITTEE
CAMAS C'nlClrri~c~, Tn~
Plame~rmittee
By ~ ~.~ ~. ~,J~
Signature of Officer
~i
SUCCESSOR OPERATOR
,QnQrcQa-fe, Srtiu,,str~ ,- WCI~. ~n~
eb Successor .
a.. ~~_
Signature of Officer
_ ; ~'
Title of Officer Title of Officer '
NOTARY FOR PERMITTEE
Stan: of )
County of 1
The foregoing instrument was aclmowledged before me this day of , _, by
as of
Notary Public
My Commission Expves
~ n_ , _ ~_ NOTARY FORS CF OR
Stan; of ~ )
County of C~.~iT.~r.~J )
.,~T-he~f~oregoing//i~~ns~~trument was aclmowledged before me((t``his /S~7 day of ~, ~~~~..~~~~~~, by
(.f/~ as ~1taC~lYC. 6C_ of
`t S ORERMA~

' Notary Public ~~~.~
My Commission Expires 38 o20B