PERMFILE137701

• Permit No: M1985170
• IBM Index Class Name: Permit File
• Doc Date: 9/3/1985
• Doc Name: Limited Impact 110 and Special Ten-day 111 Permit Application Form
• Media Type: D
• Archive: No

r~
U
cs-L-46, P. 5

c-oi2846i - R/w
STATE OE COLORADO:
SS
COUNTY OF DENVER
~, EDITH JACODOZZI , A NOTARY PUDLIC IN ANO FOR THE SA IG COUNT'S
AND SIAT E, UO HERCCY C ERTI FY THAT ON THIS r)~ TII DAY O~ JANUARY) ~~671
C EFORE ME PERSONALLY APPEARED EVERETT K. !.IE EDIN ~ ~CEI NG TO ~+E
~A~ SUP ~fiVl Sl~f`Y ~S ~~UDICATOR,
PERSON4LLY WELL KNOWN AND KNOWN BY MC TO DE TNC AVJ .).;FY~,P:N Xx 2xtcX•' XX
BRANCH OF LANDS WtUUl)(7:1)p7~(IXI)O,y(, BDREAU OF LAND MA NAGEM[NT, AND
ACKNOWLCDGED THAT THE FOREGOING INSTRUMENT HEARfNF. DATE O( JANUARY 5~
1967 , WAS FXE CIIT CD OY MIN IN HIS OFFICIAL CAPACITY AND 9Y
AUTHORITY IN HIM VESTED HY LAW, FOR T11E PURPOSES AND INTENTS
IN SAID INS7R UMCNT DESCRIUED AND SET FO~T!H ANID~pARCyK~N/O^W'LIEDG EAD.7 R
THE SAMC 70 BE NIS FREC ACT AND DECD AS A~~vK.,V'VM~KIX%MkN'aTiv1~,C I}RANCH
OF LANDS~A:WG>1X MGYACit KDTX, BUREAU OF LAND MA NAC(MENT.
I.JITNEJS MY HAND AND SEAL THIS TH DAY OF JANUARY, ~q67
r
i.-'
N TARY PUBLI
MY COMMISSION EXPIRES AUG. 2~, 1967.