REV105246

• Permit No: M1979166
• IBM Index Class Name: Revision
• Doc Date: 9/29/1997
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO3
• Media Type: D
• Archive: No

• •
-5-
Permittee and Successor hereby request the State to consent to the assignment
of the Permit, to recognize Successor as Successor Operator under the Permit,
and to accept the tendered substitute Performance and Financial Warranties in
place of the Warranties presently on file with the State.
PERMITTEE
~~PL ~.uN6'/i
Name of Permittee
~gnature of Officer (QQ/
/J [~~-
Title of Officer
NOTARY FOR PERMITTEE
State of )
County of )
The foregoing instrument was
of ~ ~ by
as ow ~lr-vs
NOTARY FOR SUCCESSOR
State of
County of
SUCCESSOR OPERATOR
~Rgu~~'s r?°~k t ~~~
Name of Successor
BY ~~ OIS~A,~.J~~
Signature of Officer (~
Title of Officer
acknowledged before me this ~~ day
The foregoing instrument was acknowledged before me this
of
as
of
Notary Public
by
day
My Commission Expires
Notary Public
My Commission Expires - ~