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NOTARY FOR STRUCTURE OWNER WITHIN 200 FT OF REVENUE MINE AFFECTED <br />AREA <br />ACKNOWLEGED BY: <br />Structure Owner / / Name ���I r 3 COUP they <br />Date S I kite , Z 0/S Title &Aol M►ncrm s Lrms,ha / �aM9eY <br />STATE OF D60,db ) <br />ss. <br />COUNTY OF ) <br />The foregoing was acknowledged before me this -play of , 20�, by <br />J. 5 �ass) id��bt t4w� Wk At [ad—('�s' <br />My Commission Expires:_ 4 )O( 2011 <br />Nota Public <br />SHERRY LEAD <br />NOTARY PUKIC <br />STATE OF COLORADO <br />NOTARY ID 70031401041 <br />d1Y MAMOiNN E>D�tES MrL 201! <br />