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- 2 - <br /> This form has been approved by the Mined Land Reclamation Board pursuant to sections 34-32-119, C.R.S., <br /> of the Mined Land Reclamation Act and 34-32.5-119, C.R.S.,of the Colorado Land Reclamation Act for the <br /> Extraction of Construction Materials. Any alteration or modification of this form shall result in voiding any <br /> permit issued on the altered or modified form and subject the operator to cease and desist orders and civil <br /> penalties for operating without a permit pursuant to sections 34-32-123, C.R.S., of the Mined Land <br /> Reclamation Act and 34-32.5-123, C.R.S., of the Colorado Land Reclamation Act for the Extraction of <br /> Construction Materials. <br /> Applicant and Successor hereby request the State to consent to the assignment of the Permit Application to <br /> recognize the Successor as the Applicant under the permitting process. <br /> U-12-61U, L� >r U'{' Green Plains Cattle Company LLC <br /> Name of Permit Applicant Name of Successor Applicant <br /> By By_ <br /> Signature of Officer Signature Of et <br /> �sE tvU��l, �NA�(�e�-- V c�E•�P�to��rfi <br /> Title of Officer Title of Officer <br /> NOTARY FOR PERMIT APPLICANT <br /> STATE OF ) <br /> ss. <br /> COUNTY OF ) <br /> The foregoing instrument was acknowledged before me this day of , <br /> by as of <br /> NOTARY PUBLIC <br /> My Commission expires: <br /> NOTARY FOR SUCCESSOR APPLICANT <br /> STATE OF Otl ) cu P ) <br /> w ) <br /> COUNTY OF ) ss. <br /> The foregoing instrument was acknowledged before me this day of..� WLJ- <br /> by JbIA �AkYI�til vl as bbYl a MIN &jt& e < Ou of <br /> �t,Itt.NS GIt1i1,E C�vwP�t-rd, � <br /> NOTAR LIC <br />