Laserfiche WebLink
CERTIFICATION <br /> The Applicant, Carol Ann Pit, LLC,by Robert W. Newby & Carol Ann Newby,does hereby <br /> certify that Century Link (structure owner)shall be compensated for any damage from the <br /> proposed mining operation to the above listed structure(s) located on or within 200 feet of the <br /> proposed affected area described within Exhibit A, of the Reclamation Permit Application for <br /> Carol Ann Pit, File Number M-1997-026. <br /> This form has been approved by the Colorado Mined Lund Reclamation Board pursuant to its authority under <br /> the Colorado Land Reclamation Act for the Extraction of Construction.Materials and the Colorado.Mined Land <br /> Reclamation Act for Hard Rock, Aletal, and Designated Alining Operations.Any alteration or modification to <br /> this form shall result in voiding this farm. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Carol Ann Pit, LLC Representative Name <br /> Date I Title 14 o.w d Q <br /> STATE OF ) <br /> )Ss. <br /> COUNTY OF } ,,// <br /> n�h <br /> The foregoing was acknowledged before me this>'!/ day o ,20 l /,q <br /> ,by <br /> OCxi/( Yyb�{ as '1GY of eQ.tZ D`� E't �t L. - '' <br /> My Commission Expires: �! :2-7 <br /> otary Public <br /> DANETTE M SCHLEGEL <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20034006913 <br /> My Comm sWw Expires February 27.2019 <br />