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REV91141
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REV91141
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Entry Properties
Last modified
8/25/2016 3:12:44 AM
Creation date
11/21/2007 11:09:18 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980049
IBM Index Class Name
Revision
Doc Date
2/20/2001
Doc Name
TRANSFER OF PERMIT & SUCCESSION OF OPERATORS APPLICATION FORM
Type & Sequence
SO1
Media Type
D
Archive
No
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' .' <br />-~- <br />PERhIITTEE <br />--L1 -rc. ~ e ~ .n Mo -~' <br />Name of Permittee <br />Signature of Officer <br />Ow,tJ~ r <br />Title of Officer <br />SUCCESSOR OPERATOR <br />.~0/1 a/c~ R. Na r ~' <br />Name of Successor <br />sy <br />Signature of 0 icer <br />Dr..~g- <br />Title of Officer <br />NOTARY FOR PERMITTEE <br />My Commission Expires~0y -G7 - <br />NOTARY FOR SUCCESSOR <br />sate of C-al ~ ~ ~ ) <br />) <br />County of l7el {~, 1 <br />The foregoing instrument was aclmowledged before me this ~~day of v 76iU j.-, by- <br />ti r~rQ~- <br />Notary Public <br /> <br />;:_ <br />- . ' ~;•~- <br />The foregoin inctn,mrnt was aclmowledged before me this I" b " day of SOY X00 ~, br,= .~; <br />~Q l' - ~ '-.. .-. ; <br />I Jrl l~ n ~ ~ f L (~, r~" 1 as c> L~.C~~t"-f S U Y' ©~pp ~~y /` of <br />Notary Pu li <br />My Commission Exp' 0 y '-D'/Ya OU~ <br />State of l O ~ 0 r'[c~X 0 ) <br />~j~ // ) <br />County of L JCS L~T~ ) <br />
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