Laserfiche WebLink
CERTIFICATION <br /> The Applicant, City and County of Broomfield (print applicant/company name), <br /> Brennan Mlddleton Water Resources Manager <br /> by (print representative's name), as i (print <br /> representative's title), does hereby certify that DCP Midstream _ (structure owner) shall <br /> be compensated for any damage from the proposed mining operation to the above listed structure(s) <br /> located on or within 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br /> Resource <br /> Permit Application for Heit Pit _ (operation name), <br /> File Number M-2003.016 <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br /> authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock, Metal,and Designated Mining Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant representative Namen'� - <br /> Date I 12--1_Z- 3 Title yJ a f-e r t2e-5 S OA/ -u-1e-- <br /> STATE OF( IQCra <br /> ss. <br /> COUNTY 00 ) <br /> he foregoing was acknowledged before me thisi2 day of ¢.r , 20 - <br /> 23, by <br /> as --F m ,e 1 l- <br /> My Commission Expires: hd U- t I' ZQ ZS <br /> Notary Public <br /> ECATHE:RIN:E :ARRIS <br /> BLICLORADO <br /> 14005321S FEBRl1ARY ]2025 <br />