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-7- <br />upon such lands. <br />15. The additional stipulations set forth in the attached rider, if any, are incorporated <br />herein by reference. <br />/ X/ a) Rider is attached. <br />/_/ b) No rider is attached. <br />ACCEPTED AND AGREED: <br />By a <br />Operator Title <br />STATE OF t7l Oak ) ss <br />COUNTY OF OUXt ) <br />DIVISION OF RECLAMATION, MINING & SAFETY <br />COLORADO DEPARTMENT OF <br />Division Director <br />The oregomg instrument was acknowledged before me this 13 day of 20-L� by <br />asQ+ W QY(;, <br />of TW L&64M 1 � operator. <br />My Commission expires: <br />41W ut, <br />APRIL LEIGH SHOEMAKER JOHNSON <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID 20124018146 <br />MY COMASSION EXPIRES APRIL 2, 2016 <br />