Laserfiche WebLink
. R <br /> CERTIFICATION <br /> The applicant, Oldcastle SW Group, Inc. , represented by Rich Umbel <br /> as, President ,does herby certify that United Power Company(structure owner)shall <br /> be compensated for any damage from the proposed mining operation to the above listed <br /> structure(s), if any exist at the time of mining and are located on or within 200 feet of the <br /> proposed affected area described within the Reclamation Permit for Wattenburg West,File <br /> Number M-2005-066. <br /> This for►n has been approved by the Colorado Alined Land Reclamation Board pursuant to its authority under the <br /> Colorado Land Reclamation Act for the Extraction of Construction klaterials and the Colorado rblined Land <br /> Reclamation Act for Hard Rock, Aletal,and Designated Alining Operations. Any alteration or modification to this <br /> form shall result in voiding this form. <br /> ACKNOWLEDGED BY: �' (Signature of Officer) <br /> Applicant Oldcastle SW Group. Inc. Representative Name: Rich Umbel <br /> Date: Title: President <br /> STATE OF ) <br /> )ss. <br /> COUNTY OF <br /> The foregoing was acknowledged before me this 1 day of -,74 , X0 l ,by <br /> T <br /> I 1 <br /> My Commission Expires: PI `O- HEIDI R.VEACH <br /> 6ortirtIssiom Number701199 <br /> Notary Public My Commission Expires <br /> c« January 14,2024 <br />