Laserfiche WebLink
CERTIFICATION <br /> The Applicant,Asphalt Specialties Co.,Inc.by Daniel W. Hunt, as President, does hereby certify <br /> that the Phyllis Burkgren (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 /> File number M 2021-067, the Stiles Mining Resource. <br /> This form has been approved by the Colorado Mined Land Reclamation Board <br /> pursuant to its authority under the Colorado Land Reclamation Act for the Extraction of <br /> Construction Materials and the Colorado Mined Land Reclamation Act for Hard Rock,Metal, <br /> and Designated Mining Operations Any alteration or modification to this form shall result in <br /> voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Applicant: Asphalt Specialties Co., Inc. Representative Name: Daniel W. Hunt <br /> Date: rl/-q/zv Title: President <br /> STATE OF Colorado ) <br /> ) SS. <br /> COUNTY OF Adams ) <br /> 2.2^ <br /> The foregoing was acknowledged before me this _day of/VoJe,, bf49-, 20�±,by <br /> Daniel W. Hunt as President of Asphalt Specialties Co. Inc. <br /> aOAQO�— My Commission Expires: 2� <br /> No Public <br /> JAN NELSON <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 19MO30527 <br /> My Commission Expires April 29,2024 <br /> H:\Pits HBP Plants\EVANS\Evans Mining Resource\Exh S-Permanent Manmade Structures\Letter Structure Agreement Burkgren.doc <br />