2013-02-04_REVISION - M1997084

• Permit No: M1997084
• IBM Index Class Name: REVISION
• Doc Date: 2/4/2013
• Doc Name: SO-02 APPLICATION
• From: OPERATOR
• To: DRMS
• Type & Sequence: SO2
• Email Name: WHE
• Email Name: GRM
• Media Type: D
• Archive: No

STATE OF COLORADO )
) ss.
COUNTY OF OURAY )
The foregoing instrument was acknowledged before me this 21' day of December, 2012, by
Dominic Mattivi, Jr., as Sheriff of Ouray County, Colorado.
Witness my hand and official seal.
My commission expires:
2