2019-11-27_PERMIT FILE - M2019058 ‎(19)‎

• Permit No: M2019058
• IBM Index Class Name: Permit File
• Doc Date: 11/27/2019
• Doc Name Note: Exhibit S - Permanent Man-Made Structures
• Doc Name: Application
• From: Colorado Sand Company LLC
• To: DRMS
• Email Name: MAC
• Email Name: BFB
• Media Type: D
• Archive: No

S-38
NOTARY FOR STRUCTURE OWNER
ACKNOWLEGED BY:
Structure Owner NBL Midstream Holdings LLC _
) I-- _``
Representative Name
G'<..r
Date Title ,4C
STATE OF
) ss.
COUNTY OF / � � )
The foregoing was acknowledged before me this,'=�day of `f Tt j��- j� , 2019, by
C- f -1" \IIA r)6efi =as 7-TT(,0-,t- of
-, My Commission Expires: '
Notary Public
_ DONNA L TODD
Notary Public
State of Colorado
Aotary ID#20044006032
"or)mission Expires 08-14-2023
Keenesburg No. 2 Mine—Reclamation Operation—November 22, 2019