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2008-10-17_REVISION - M1999120
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2008-10-17_REVISION - M1999120
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Last modified
6/16/2021 6:12:43 PM
Creation date
10/20/2008 10:27:20 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1999120
IBM Index Class Name
REVISION
Doc Date
10/17/2008
Doc Name
Adequacy Review Resonse and Extension Request
From
L.G. Everist, Inc.
To
DRMS
Type & Sequence
TR3
Email Name
ECS
Media Type
D
Archive
No
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The notarized signatures of the Structure Owner Representative and the Applicant <br />Representative confirm the Agreement between the parties and the repair/compensation <br />obligation of the Applicant as stated above. <br />IN WIT WHEREOF, the parties have executed this Agreement effective as of the <br />day of?SS , 2004. <br />MY Commission Expires Jan. 22,200 <br />Agreed by the Applicant: <br />Signature of Representative for L. G. Everist, Inc. <br />L. G. EVERIST, INC. <br />D -a V <br />ate <br />Name and Title (please print) <br />State of Colorado ) <br />)ss <br />County of 0A0j-a5 ) <br />e foregoing instrument was acknowledged before me on this ,;?4 day of <br />2004, by the signatory Representative above. Witness my hand and <br />official seal, <br />Notary <br />??taaY ?te?? . <br />ME: My Commission Expires. ? • ??p <br />esq., ,aOO <br />rFOF •CO?OQP <br />FL-LBDCAgreement-Sep2004.DOC 10
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