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<br />- <br /> <br />WMl-3 <br />CO DNR <br />Sept. 85 <br /> <br />I certify that to the best of my knowledge the information contained in this <br />application is correct. <br /> <br />Signed <br />Date <br /> <br />Subscribed to and sworn before me this _____ day of <br /> <br />19_. <br /> <br />Notary Public <br /> <br />SEAL <br /> <br />My Commission Expires on <br /> <br />5163 <br />