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SENT SY~ <br />,~ ~ _ -- - - <br />Project( <br />PrOlect Owner <br />Contact Name <br />Briet Descripslon of Project (Include location and size) <br />33 <br />303 832 8106;# 2/ <br />1 ~ Orojec-F is Iecat~c! rn nel+h cen-Fro) IVewN4eXlC0 <br />rind work wds Oer~~m -~orthe.~ corrl~r11~c-Fcr i„rJ,r~}'r i~dude~ <br />le ...~.+ o~ r~rorn~[. ~Q ~)r•IGS ~ I~Umrd Piprna d- a'wa,IV~ j <br />Iez~loe•+ err~.r ~r slTnt~stgbrli~!-rmrj and leyoa-r~ o~ <br />/rrJ Otrn Ct+hitrvrf--DACOnOaa~ <br />Project Nsma Dste(sl <br />Prvjett Owner , <br />Contsa Nerve Phone <br />Brief Deicripdon of Project (include location and size- <br />The undaraipned sprees m C0n1p1y with ail Rules artd Rapulations of the Colorado Surface Coal Mlnino <br />Reclamation Act, the General Cortdisions ol.ths Purohese Order end the Pun:haae Order Terms and <br />Condhkne and aN other nauiramenU of these dOCUmensa: <br />~ r <br />Individual or Company Nerve T r y t/ e n a w S U l i-1 n A.. Eh~ i!1 ee r i t" 9 <br />Profesiwnal Certircation No- ~o)ora~n ~~¢, <br />Sipnatura ~.+~~ Date 8- 3d- 95 <br />Address 28 CJrarfz Stree~- <br />~sUhe isaR ~ 8130 <br />Phone .~g~Pl 6~J-339~- <br />T` ~~ vsw 7 0+ ~ Peas <br />8-30-95 5~O1PM ; T11E PAPER CLIP <br />O.C. #l2 Coal Mine - Pem+is No. C-SO-002 <br />Prior ExpeTfenoe <br />_ _ WaS+e- Atut. <br />