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- 2 -A.. <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 /> &#-y-GILT, (-k a , ft'E V�-, L- { Green Plains Cattle Company LLC <br /> Name of Permit Applicant Name of Successor Applicant <br /> By By <br /> Signature of Officer Signature Of i er <br /> { ,,,u 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 0Wk ) <br /> w q ) <br /> COUNTY OF ) ss. <br /> The foregoing instrument was acknowledged before me this day of <br /> by �O-K"(il✓1 as 6 d1'I P.Itid� 1'l H llti�Ctt ' �� f <br /> (��yv�c,htu5 G�fi1.E C�rrrN, �- <br /> NOTAR LIC <br />