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Construction Materials (C.R.S. § 34-32.5-101 et. seq.) ("Construction Materials Act") and <br /> associated Rules (2 C.C.R. 407-4) ("Construction Materials Rules"), with respect to any other <br /> operation conducted by the Prospective Successor in the State of Colorado. <br /> Permittee and Prospective Successor hereby request that the Mined Land Reclamation <br /> Board ("Board") approves their SO Application, recognizes the Prospective Successor as <br /> Successor Operator under the Permit, accepts the Prospective Successor's Performance and <br /> Financial Warranties, and releases the current Permittee's Performance and Financial Warranties. <br /> SIGNED, SEALED AND DATED this_ t0 day of <br /> PERMITTEE PROSPECTIVE SUCCESSOR <br /> Pine Bluffs Gravel and Excavating, Inc. Mid-States Materials, LLC <br /> Name of Permittee Name of Prospective Successor <br /> By By <br /> Zg1 ature of Offi Signature of Officer <br /> Title of Officer Title of Officer <br /> NOTARY FOR PERMITTEE <br /> STATE OF ) <br /> 1 � ss.: <br /> COUNTY OF L_fr�r�;2 ) <br /> The foregoing instrument was acknowledged before me this_L�day of , <br /> by as hCt Cy.� of Pine BIA Gravel and Excavating,Inc. <br /> Notary Publics <br /> DEBO AH L M4RGAN My Commission Expires 2)"Aci <br /> Notary Public -state of Wyoming <br /> Commission ID N 120606 <br /> My Commission Expires <br /> December 31, 2029 <br /> - 9 - <br />