2015-07-23_PERMIT FILE - M2015030

• Permit No: M2015030
• IBM Index Class Name: PERMIT FILE
• Doc Date: 7/23/2015
• Doc Name: Application
• From: Asphalt Specialisties Co., Inc.
• To: DRMS
• Email Name: ECS
• Email Name: WHE
• Media Type: D
• Archive: No

AFFIDAVIT OF RECEIPT
State of Colorado
County of Weld
BEFORE ME, a representative of the Platte Valley Conservation District, on this
2 :� day of I L1 , 20_j5 , I did receive a copy of "Notice of Filing
Application for Coloradb Mined Land Reclamation Permit for Regular (112)
Construction Materials Extraction Operation-Chavers Mining Resource".
Signature hk ` �-q
(M,c { V_ C("
Name (printed)
N RCS Co c�or
Title (printed)