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SIGNED, SEALED AND DATED this_oil day of U*be(- 2016 <br /> Cheyenne County <br /> Operator (SEAL) <br /> By: <br /> Title: Chairman <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF ) <br /> ss.: <br /> COUNTY OF ) <br /> _fore{�oi g nstrument was acknowledged before me this�day ofby .The <br /> LC t'iAibvl as of <br /> PATRICIA A.DAUGHERTY Notary Public <br /> NOTARY PUBLIC <br /> STATE OF COLORADO My Commission Expires <br /> NOTARY ID 2015400744E <br /> MIf CONrIS O IRES FESRUARY 2D 2M <br /> STATE OF COLORADO <br /> DEPARTMENT OF NATURAL RESOURCES <br /> MINED LAND RECLAMATION BOARD <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> By: Date Executed: <br /> Division Director <br /> Rev.05/12 <br /> - 3 - <br />