Laserfiche WebLink
CERTIFICATION <br /> The Applicant, Transit Mix Concrete Co. (print applicant/company name), <br /> by Jerald Schnabel (print representative's name), as President (print <br /> representative's title), does hereby certify that Black Hills Energy (structure owner) shall <br /> be compensated for any damage from the proposed mining operation to the above listed structure(s) <br /> located on or within 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br /> Permit Application for Hitch Rack Ranch Quarry (operation name), <br /> File Number M-2016-010 . <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br /> authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock,Metal, and Designated Mining Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Representative Name Jerald Schnabel <br /> Date Title President of Transit Mix Concrete Co. <br /> STATE OF ) <br /> ss. <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this day of , 20 ,by <br /> as of <br /> My Commission Expires: <br /> Notary Public <br />