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REP14742
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REP14742
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Entry Properties
Last modified
8/24/2016 11:44:31 PM
Creation date
11/27/2007 1:30:08 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1978146
IBM Index Class Name
Report
Doc Date
9/24/1991
Doc Name
MLR DIV ANNUAL FEES
Permit Index Doc Type
ANNUAL FEE / REPORT
Media Type
D
Archive
No
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• III IIIIIIIIIIIII III <br />999 <br /> <br />LOGA,N COUNTTY STERLING, C0303 ~/O~~?N!'_S~_~_ziS19 g~ <br />TO~~UE~~/~t%~-.~.~L~7-iu -.U1~a-~---._~R. ADDRI;SS.~d/.L!~~'..-.~_a _~'a2~---- <br />Have all bills itemized, Oli'd and acknowledged before filing with County Clerk. <br />(}ive number o:'. State Road; also specify where work was done. <br /> <br /> I e o h„~-a ell 1-t _ -j - - aD <br /> <br /> <br /> 4 r~ <br />,{ -~3-i9/- 1- ~ !~ r <br /> C <br />S) S~aPI fns ~L /l'(~ 7 ~"~ ~/ i7)- 30 <br /> <br /> ,~ <br /> O <br />STATE OF COLORADf7/L COUNTY OF LOGAN-ss. <br />I,....<-L.~SL <br />---~-----~-..-------__....--.._.-._._.-_.-_, do solemnly swear that the several hems mentioned fa the <br />annexed account are just and true, that the Articles were furnished ae therein charged, and that Lhe amount claimed, to-wit: <br />19ervicee were rendered <br />?hc sum o[ ... -.-_.. _ ___._._~~~ _ ..DOLLArR~ s du ~ nd un aid, alter allowing all 7uet cradlts. <br />(81gn Here)-f!////-////~~-'---.-_..---'-------------------------- <br />Subscribed nad sworn to before me this ................._._-day o[.__._._.-.__.._...._--..._..__-..-_~_.---_._-, 19__.. <br />Dsroxr -- ----------------------------.._..-----------°.--._......_....----. Clerk <br />- - ~~-yc,u-nave-any-questions;-please contact this office as soon as possible. <br />~j~~o9 <br />1 ~ <br />~~~ v - IJJ~ ~~]1 <br />.,.1 ~ _.~,~ X01 Vy\ <br />
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