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SIGNED, SEALED AND DATED this_ Fh day of ( 4obe�r" 2016 <br /> Cheyenne County <br /> Operator (SEAL) <br /> /J ) <br /> By: ,�.► --- <br /> Title: Chairman <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF ) <br /> ss.: <br /> COUNTY OF ) <br /> -fnoreo g"nstrument was acknowledged before me this day of <br /> by .The <br /> CQ as of <br /> PATRICIA A.DAUGHERTY Notary Public <br /> NOTARY PUBLIC Ciy\ a� <br /> STATE OF COLORADO My Commission Expires {2�Q 6%-) lU� <br /> NOTARY ID 2015400708 <br /> WCOI UM IRES FEBRUARY20 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 />