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Proof of Filing with County Clerk <br /> I, the County Clerk for County; <br /> have received a complete application package for a Hard Rock/Metal Mining Limited Impact (110) <br /> Reclamation Permit with the Colorado Mined Land Reclamation Board under provisions of the Colorado Mined <br /> Land Reclamation Act. The proposed mine is known as the (Name of the Mine) , <br /> and is located at or near Section , Township , Range Principal Meridian. <br /> Signature Date <br />