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 Land 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, Metal, and Designated Mining Operations.Anv alteration or modification to <br /> this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Carol Ann Pit,LLC Representative Name "lad <br /> V <br /> Date — _ g Title <br /> 1 <br /> STATE OF ) <br /> ss. <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me thid d y of(-,, <br /> ,20 cj, by <br /> o[Y -t YU /Vlwby as "/I of 1'1 1/1T <br /> Y� I My Commission Expires: /�-7 f 1-7 <br /> otary Public <br /> ®ANETTE M SCHLEGEL <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 2003;=6913 <br /> My commission Expires February 27,2019 <br />