_PERMIT FILE - M1980194 ‎(4)‎

• Permit No: M1980194
• IBM Index Class Name: Permit File
• Doc Name: LIMITED IMPACT 110 & SPECIAL TEN DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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PURCHASE ORDER NUMBER
E1 Paso County 3aoF3
DEPARTMENT OF PUBLIC WORKS
3170 Century, Colo. Spgs. , Colo. 80907
eller I OA'Ato Z• 1 06-611t/ Dated 3 19
i
ddress -� Refer to the above number or
L provide a copy of this order
( with any claim you may find
OF _�. necessary to file.
declare that I am owner of the real property wherein 4,1.e- J
xists and is located in Township (a) , Range / 3 W,
ection F— , Quarter [ The Department of
ublic Works may purchase from me, in the quantity
stimated below, during the period 3 / ) YD to include
'S A - r/ , subject to the following Special Provisions:
If none this will a so noted hereon) . ! - Ct.Z.
nit of Approx. No. Cost
easure of Units Per Unit
3yments to be made monthly by Warrants issued by El Paso County based upon
ae number of units purchased during prior month.
Vy (Signature of ller)
archase Order Acouired b �
/,'�Z Signa'tur/e/ .
Title
(Purchasing Agent)
irchase Order Approved by �21
Max L: Rothschild, Pit.
Director of Public Works/County Engineer