2015-03-10_REVISION - M1994117

• Permit No: M1994117
• IBM Index Class Name: REVISION
• Doc Date: 3/10/2015
• Doc Name: Incomplete SO06
• From: Gold Hill Mill
• To: DRMS
• Type & Sequence: SO6
• Email Name: MAC
• Email Name: TAK
• Media Type: D
• Archive: No

SIGNED, SEALED AND DATED this day of
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Operator — -
By:
Title:
NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT
STATE OF —� )
GN-(Ary� ss.:
COUNTY OF
The foregoing instrument was acknowledged before me this f-�o day of
by as VFW i kc, YY�.ejvX W--, of I
*Nt KAREN BALLANTYNE Notary Pu
+} Notary Public State of Utah
ECMY Commission Expires on: My Commission Expires
August 16, 2016
t�
+ Comm. Number: 658685
STATE OF COLORADO
DEPARTMENT OF NATURAL RESOURCES
MINED LAND RECLAMATION BOARD
DIVISION OF RECLAMATION, MINING AND SAFETY
Un
Division Director
-13-
Date Executed:
Z z Z:7
(SEAL)
Rev. 05/12