HomeMy WebLinkAbout975066COMES NOW, Michael G. Dusselier and Lisa Dusselier, whose address is P.O. Box
480075, Kansas City, MO 64148, does hereby make the following statement of facts:
1. That the undersigned has an interest in the land described under the Certificate of
Surveyor on the plat titled, "SALT RIVER COVE DIVISION NO. 2 -THRID
FILING WITHIN THE E1/2SE1/4 SECTION 9 NW' /4SW1/4 SECTION 10 T36N
R119W LINCOLN COUNTY, WYOMING dated 23 December 2013, as revised
and recorded concurrently herewith.
2. That the undersigned has reviewed said plat.
3. That the undersigned has read and understands the provisions of the Certificate of
Owner thereon and the implications thereof.
4. That this certificate is signed in the stead of and has the same effect as if the original
mylar of said plat had been signed.
DATED this 1 4. day of 1c9/r,(,,0 2014.
Michael G. Dusselier Lisa Dusselier
STATE OF
COUNTY OF
The foregoing ins ent was acknowledged before me by Michael G. Dusselier and
Lisa Dusselier f day of ja //,,,9,Gr.�c 2014.
Witness my hand and official seal.
Commission Expires: �J
CERTIFICATE OF OWNER'S SIGNATURE
SS.
975066 1/27/2014 9:47 AM
LINCOLN COUNTY FEES: $12.00 PAGE
BOOK: 827 PAGE: 230 AFFIDAVIT
JEANNE WAGNER LINCOLN COUNTY CLERK
111 11 1
Notary Public
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Commission Expire.