2017-02-15_PERMIT FILE - M2017004

• Permit No: M2017004
• IBM Index Class Name: PERMIT FILE
• Doc Date: 2/15/2017
• Doc Name: Application
• From: Oldcastle SW Group, dba Four Corners Materials
• To: DRMS
• Email Name: THM
• Email Name: GRM
• Media Type: D
• Archive: No

NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT
STATE OF C o LC)P.f+7Y- )
ss.
COUNTY OF LLB} F -r )
The foregoing instrument was acknowledged before me this day of
Oldcastle SW Group,Inc.dba Four Comers Materials
by as 12 (k,1QLE Miti.11}<a of
NOTARY PUBLIC
My Commission expires:
APPROVED: KRISTIN MARGUERITE ROEHRS
State of Colorado NOTARY PUBLIC
Mined Land Reclamation Board STATE OF COLORADO
Division of Reclamation,Mining and Safety NOTARY ID 20134046325MY COMMISSION EXPIRES 07/2512017
By: Date:
Division Director
M:\min\share\bondforms\Corporate Surety REVISED 25Ju12016
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