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-55
SIGNATURE PAGE TO LETTER WITH SUBJECT
Colorado Sand Company LLC—Keenesburg No.2 Mine—DRMS 112 Permit Application Requirement
for Permanent Man-Made Structures
IN WITNESS WHEREOF,the Party has executed this statement as of this 71'day of November, 2019.
NOTARY FOR UTILITY OWNER
ACKNOWLEGED BY:
Structure Owner United Power Inc. Representative Name
Date ti � - `� Title
STATE OF C U
ss.
COUNTY OF
The foregoing was acknowledged before me this-day of 2019, by
Daruji*cle— as },%vr\ of �,V�,j,�rc g �� —Y. .✓Lc-.
r R M
My Commission Expires 401-1
Notary Public
ALYSSIA B.PADILLA
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 20184015670
MY COMMM M EXPIRES 011 V=
Keenesburg No. 2 Mine—Reclamation Operation—November 22, 2019