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f1 HOLCIM <br /> V <br /> structure(s)located on or within 200 feet of the proposed affected area described within Exhibit <br /> A, of the Reclamation Permit Application T.H.E.Aggregate Source Tunnel Drive, File Number M- <br /> 1977-193. <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant <br /> 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, <br /> Metal, and Designated Mining Operations.Any alteration or modification to this form shall <br /> result in voiding this form. <br /> us <br />