Laserfiche WebLink
CERTIFICATION <br /> The Applicant, Amrize West Central Inc., by Travis Smith, as General Manager, does hereby <br /> certify that CORE Electric Cooperative shall be compensated for any damage from the mining <br /> operation to the above listed structure(s) located on or within 200 feet of the proposed affected <br /> area described within Exhibit A, of the Reclamation Permit Application for the Deer Creek Quarry, <br /> File Number M-1997-014. <br /> This form has been approved by the Colorado Mined Land Reclamation Board <br /> pursuant to its authority under the Colorado Land Reclamation Act for the <br /> Extraction of Construction Materials and the Colorado Mined Land Reclamation <br /> Act for Hard Rock, Metal, and Designated Mining Operations. Any alteration or <br /> modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Travis Smith, Amrize West Central Inc Representative Name <br /> Date / r S / Z G Title General Manager <br /> STATE OF eo 11JY'ciln ) <br /> )ss. <br /> COUNTY OF \C_ ) <br /> The foregoing was acknowledged before me this day of•-.101k4-"( , 20Z CP by <br /> v1....:s 5..* as Gb w1 Ma••rac of Afta: &tool. C,..}n•I 1 .. <br /> 1 <br /> .-- My Commission Expires: a 1a i loci <br /> Notary Public <br /> SARAN GREGA <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY FOR STRUCTURE OWNER NOTAIfY ID20174007757 <br /> he2MNISSIDN EXPIRES anima2I,:co <br /> ACKNOWLEGED BY• �Y <br /> Structure Owner Name <br /> Date Title <br /> STATE OF <br /> )ss. <br /> COUNTY OF — ) <br /> The foregoing was acknowledged before me this day of , 20_, by <br /> as of <br /> My Commission Expires: <br /> Notary Public <br /> 212 <br />