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�[__U Garfield County <br /> CERTIFICATION OF MINERAL OWNER RESEARCH <br /> This form is to be completed and submitted with any application for a Land Use Change Permit. <br /> Mineral interests may be severed from surface right interests in real property. C.R.S. § 24-65.5-101, et seq, <br /> requires notification to mineral owners when a landowner applies for an application for development from a <br /> local government. As such, the landowner must research the current owners of mineral interests for the <br /> property. <br /> The Garfield County Land Use and Development Code of 2013 ("LUDC") Section 4-101(E)(1)(b)(4) requires <br /> written notice to owners of mineral interests in the subject property in accordance with C.R.S. §24-65.5-101, <br /> et seq, "as such owners can be identified through the records in the office of the Clerk and Recorder or <br /> Assessor, or through other means." This form is proof of applicant's compliance with the Colorado Revised <br /> Statutes and the LUDC. <br /> The undersigned applicant certifies that mineral owners have been researched for the subject property as <br /> required pursuant to C.R.S.§24-65.5-101,et seq,and Section 4-101(E)(1)(b)(4)of the Garfield County Land <br /> Use and Development Code, as amended. As a result of that research,the undersigned applicant certifies <br /> the following(Please initial on the blank line next to the statement that accurately reflects the result of <br /> research): <br /> _ I own the entire mineral estate relative to the subject property;or <br /> X Minerals are owned by the parties listed below <br /> The names and addresses of any and all mineral owners identified are provided below(attach additional pages <br /> as necessary): <br /> Name of Mineral Owner Mailing Address of Mineral Owner <br /> Sweene 's, Inc. Unknown <br /> J. Gentry, F. Gentry P.O. Box 1300 Rifle Colorado 81650 <br /> Marvell Couey, Kelly Couey 6275 County Rd. 315, Silt Colorado 81652 <br /> United States of America Notice address unknown <br /> I acknowledge I reviewed C.R.S.§24-65.5-101,et seq,and I am In compliance with said statue and the <br /> LUDC. <br /> 2,( <br /> Applicant's Signature Date <br />