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REV93083
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REV93083
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Entry Properties
Last modified
8/25/2016 3:14:26 AM
Creation date
11/21/2007 11:27:24 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1981068
IBM Index Class Name
Revision
Doc Date
4/29/1993
Doc Name
TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
Type & Sequence
SO1
Media Type
D
Archive
No
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' 'h aPR OS '93 <br />~r <br />ERMITTEE <br />-3- <br />{Y~s /GMN ~•40~•IIG ~B~"~~~MN IMf..• <br />ame of Permitter <br />By <br />S gnature of Officer <br />l~iac. Pre.s~o~e.K~ <br />1~1t1e of Permittee <br />NOTARY FOR PERMITTEE <br />State of C,~~ -s who ) <br />County of C3•n.•4`~mlea ) <br />• • <br />P.6i11 <br />SUCCESSOR OPERATDR ' <br />G..w.~~ ~res.GoRSi'. t;.feJi <br />~~ab;l; ~ Co <br />Name of Succ ssor <br />By <br />Signature of ofi•~cer <br />yJ0. r~ ~ a~ ~ 1 }~f . G rgq0. N } <br />RCq /StGM GO^ AQ ~h~ <br />Title o Successor Opera r <br />The foregoing instrument was acknowledged before me this __,~~_~ day <br />of ~Ly//(..~~o ~ ~ l , ~ ~ 9;, by c ~ • (.t~ a e. r- // <br />as V ACC. ~1'GS1~EK} of (IJeS~GFVt me,0i B ~o <br />NQTnRY FOR SUCCESSOR <br />'State of C e~o--d o.~~o ) <br />County of ~arPi e•~e~l ) <br />Notary Publi CLuP 9!~J( <br />My Commission xpi rest !J - <br />rNL <br /> <br />The foregoing instrument was acknowledged before me this ~~ day <br />Of , J /993, by ,Da„ ;a/ _~• Gr r0. hf <br />as n~,iTGNC~ 11~p..+ of Cyran+' Qres_G.hs~- l.to~l l.awbi?~fy <br />Notary Puhlic R.u-~ ~ ZV <br />My Commission xpires a-~3-9 <br />. • •:~:=~ <br />. ~~ _ . <br />„d l.i~ ~ ~~ I ~ <br />SD:SSgM LI'JiI1IIVERRLS&GEULUGY <br />• <br />
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