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REV89893
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REV89893
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Entry Properties
Last modified
8/25/2016 3:11:43 AM
Creation date
11/21/2007 10:57:26 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1986007
IBM Index Class Name
Revision
Doc Name
TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
Type & Sequence
SO1
Media Type
D
Archive
No
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<br /> <br />-5- <br />Permittee and Successor hereby request the State to consent to the assignment <br />of the Permit, to recognize Successor as Successor Operator under the Permit, <br />and to accept the tendered substitute Performance and Financial Warranties in <br />place of the Warranties presently on file with the State. <br />PERMITTEE SUCCESSOR OPERATOR <br />~A~o vV. 8~co// ,.-~c nl~ Sc.~~-tl~w ~ cK <br />Name of Permitt Name of Successor -. <br />_ ~~, ~ ' <br />By BY r~G ~ /' fi~./~ <br />Signatur of f icer signature of Officer <br />tle f Officer Title of Officer <br />NOTARY FOR PERMITTEE <br />State of ~~~Ic;; ~.Y.(/C~ ) <br />~) ) <br />Cwnty of _~?`~'~ ) <br />The foregoing instrument was ac~kn/g~wledged before ,this s ~U ~`qq day <br />of~~,lc!rr ~GU) /~9a' , by ~__~J ~1X ~ ~~J.~C/O <br />as ~,.~,cr_~~' of Al4 <br />Notary Publ i c ~ ,~ ~ ~ r ~i~ <br />My Commission Expires ~_/7-,~OD~. <br />NOTARY FOR SUCCESSOR <br />State of ~f,//,7~~i'D ) <br />County of Li/~.l~~l~~ ) <br />The foregoing instrument was ackn/owledged/before me this ~~Qcly day <br />of lii~ /99,p', by "~_ 9~•~ri0 1~-c.~fi~~i~~C <br />Notary Publicy~GZ,~r~ ~[~~:i.~~~ <br />My Gommission Expires ~-/7-,~4ci~ <br />
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