Laserfiche WebLink
CERTIFICATION <br /> The Applicant, W.W. Clyde&Co. (print applicant/company name), <br /> by John Thompson (print representative's name),as Senior Vice President (print <br /> representative's title),does hereby certify that Colorado Department of Transportatio(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 Rifle Gravel Pit#1 (operation name), <br /> File Number M- 2021- 052 <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 W.W. Clyde & Co. Representative Name <br /> Date ,rAp/Z92....4 Title Senior Vice President <br /> STATE OF Colorado ) <br /> ) ss. <br /> COUNTY OF Arapahoe ) <br /> The foregoing was acknowledged before me this day of ,z f , 20 , by <br /> J h) -Tn p cci as J`''.e n;en k pAigi-t d-of Lc) , &� c'i.rd PI £ co, <br /> (17L -'" ..e-/--Lett My Commission Expires: t q t 11. -ee <br /> Notary lic <br /> MITZI REECE <br /> Notary Public <br /> State of Colorado <br /> Notary ID#20184011940 <br /> My Commission Expires 05-09-2026 <br />