Laserfiche WebLink
std WSJ <br /> CERTIFICATION <br /> The Applicant,Turquoise Connection (print applicant/company name), <br /> by Foster G.Scott (print representative's name),as President (print <br /> representative's title),does hereby certify that Cripple Crk Black Hills Energy cture owner)shall <br /> be compensated for any damage from the proposed mining operation to the above listed structure(s) <br /> located on or within 200 feet of the proposed affected area described within Exhibit A,of the Reclamation <br /> Permit Application for Scott Blue II <br /> (operation name), <br /> File Nilmber M-2007_031. <br /> This form has been approved by the Colorado Mined Land Reclamation Briard pursuant to its <br /> authority under the Colorado Land Redamation Acifor the Extraction of ConstruCion Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock,Metal,and Designated Mining Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: / <br /> Applicant 1h e-LAO go;X C-r%lveGti<4Representative Name o 5 f C'/l. tJ'. 5 C <br /> Date ' /$- 20/'J Title Ail P,5;404e,(/ <br /> rf <br /> STATE OF ME.6Thti ) <br /> COUNTY OF Bulk/? )ss <br /> • <br /> The foregoing was acknowledged before me this le day of 5EPT ,20 7 by <br /> FOSTER 6 S-e.077 as PRCSf,JEM T of-TOR.1JD/SE fY fL71D,c) <br /> IPA . /a y Commiecion Expires: 02// /!.0 <br /> Notary Public <br /> OFFICIAL STAMP <br /> ••• VICKI LYNN CUNNINGHAM <br /> NOTARY PUBLIC-OREGON <br /> • COMMISSION NO.947584 <br /> MY COMMISSION EXPIRES FEBRUARY 18,2020 <br />