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2023-06-21_REVISION - M1977057 (2)
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2023-06-21_REVISION - M1977057 (2)
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Entry Properties
Last modified
6/22/2023 8:40:24 PM
Creation date
6/22/2023 8:06:12 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977057
IBM Index Class Name
Revision
Doc Date
6/21/2023
Doc Name
Structure Agreement
From
Camilletti LLC
To
DRMS
Type & Sequence
SO3
Email Name
SMS
ZTT
AME
AWA
Media Type
D
Archive
No
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CERTIFICATION <br /> The Applicant, Camilletti LLC (print applicant/company name), <br /> by Darrell Camilletti (print representative's name),as Managing Member (print <br /> representative's title), does hereby certify that Western Area Power Administration(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 /> Permit Application for Fedinec Pit (operation name), <br /> File Number M-1977-057 . <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: ,( l <br /> Applicant WL I l r L p Representative Name A��) <br /> �Q.. � <br /> Date 6 l l Z� Title malu-44A�n&1- <br /> STATE OF6,,�W4_) <br /> ss. <br /> COUNTY OF�) <br /> The foregoing was&Z. <br /> ledged before me this 8�day ofL ,20 z3 by <br /> CA , as of <br /> My Commission Expires: <br /> NotaiyNblic <br /> DELAINE BROWN <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> F <br /> OTARY ID#20054041994 <br /> ommission Expires Ocfter 27,2025 <br />
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