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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 <br /> and the Colorado Mined Land Reclamation Act for Hard Rock, Metal, and Designated Mining <br /> Operations. Any alternation or modification of this form shall result in voiding t l <br /> Applicant: Hall-Irwin Aggregates, LLC By: f, <br /> �-1 Bret Hall, Manager <br /> Date: ^�—�� t , 2017 <br /> NOTARY FOR PERMIT APPLICANT <br /> STATE OF COLORADO ) <br /> ) <br /> COUNTY OF WELD ) <br /> The foregoing was acknowledged before me this,-'91Uday 2017, by Bret Hall as <br /> 7Commiss�ion <br /> A LC,the Applicant. <br /> Public <br /> Colorado g,�l'� - ice _ <br /> 9964021059 i <br /> x fires 12-05-2020 Notary Public Myexpires: <br /> SIGNATURE OF STRUCTURE OWNER <br /> Structure Owner: LARAMIE RIVER DEVCO LP Si <br /> By: Laramie River DevCo GP LLC,its general partner Erik an Decar,Attorney-In-Fact <br /> By: Noble Midstream Services, LLC,its sole member <br /> Date: �/ Z�f-7 <br /> NOTARY FOR STRUCTURE OWNER <br /> STATE OF COLORADO ) <br /> COUNTY OF WELD ) <br /> The foregoing was acknowledged before me this g"day of Junet , 2017, by Erik T.Van Decar as <br /> Attorney-In-Fact of Noble Midstream Services, LLC, in its capacity as sole member of Laramie River <br /> e r I partner of Laramie River DevCo LP. <br /> KATHRYN ORR <br /> Notary Public—State of Colorado <br /> Notary ID 20134035824 <br /> My Commission Expires Jun 10,2021 <br /> Not y Public <br /> My Commission expires: -/0­Z( <br />