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EXHIBIT R — PROOF OF FILING WITH COUNTY CLERK AND RECORDER <br /> Copies of the receipt from the County Clerk and Recorder is attached below. <br /> STATE OF LOLORADO <br /> DIVISION OF MINERALS AND CE01.00 --.- - ---- --. ---- ---,-_�.� <br /> Jep,trblie:'I n' �,LI:a kesu�rt ee <br /> I,.l er:•,a„�I .r<Wn,,l; Pt'L)r1 ✓f!Ct //- /�� ' c^�> <br /> :.aiq,atlu J0.0; <br /> CONSTRUCTION ♦tATEMAI9 IN I N E, RA L <br /> REGrLAR (112) OPERATION --6`—� <br /> RLCLAp1ATION PERMIT APPLICATION FORM (1 E O L O G <br /> aECI.AMATIQ <br /> M N NG•S1rF.- <br /> IIIII l...n, ----- <br /> f.;mer:nr <br /> Tbere la a Fite Number Altrad%Aaillned to IhIA Operation <br /> Pumm ti M. ,. _ _. (rleasu refcrewe the rile number currnnuv assigned to dos operauan) Ewcuuva Duran. <br /> N:I Ada'd I <br /> _KX New Application trine 1 A i) _ _ Amendment .1pp4u4uou Ttulc 1 10) o,, <br /> _Conversion Application tikulc I 1 1) <br /> P:rrnn k NL- _ ..__ (pinvade for Amendments and Converskms of exisriug penruts) <br /> The npplicamn for a C:owimurion Vateriuls Regu:nr 112 C*,ratrou Reclninatiou Parnrit contains dime major parts. (1) the applicarilm yarn. <br /> (2)1-xhibit� rs-S,.Wdwnlni 1,anp auctions nt Lxtubti 6 c k(;witr;Inu:al Stab)iity L•xitihi:;and(3)the npphowien fee when you submit your <br /> nppbcnnon, be sure to mclude out (1) gotriviric elm ed and notarized IVORY ORIGINAL and four (4) wplcs of the enmpiered Ivan, <br /> applldlC,llr I'o=, Ilve (1)copleb 0! 1•.Rillbar]A-S.:l,ddendnnl 1,apprnpnule secriuus of 6.3(Clenteo6nicai Suah]ity ExLibil, and a ch:ck for <br /> the appllca:rou let described roller Scotion (1) below. L..eltil•us should NOT be bowed or ua n 3-naR biudcr� viape should he. folded to <br /> tl 1:"X 1 1"or i il_" K :4" sox. to exptditg pr:a assrng,please provide tae mtbnudtiou in the format and order described to tbia turn <br /> GENERAL OPLRATION INFORMATION <br /> Type or print clearly,In the space pnrvidtid,all information described below. <br /> I Apnllcantlontrawr or comnanv ppme(mime to he u itl: <br /> '.-ail-_rwin Coroo ';icion <br /> !.l Type of orgleni2arlula t xirl)urntrutl, partlrer5hrp ew.i. rnr�JL+ T]0 0 __...-- - <br /> 1.2 1.R.S.Tax !.D. Nn nr Cnci)d Security Numbur: '4-0(,24573 <br /> 2. !)jLerudij) natmclnLminenr>fltename). No,th Le�nllfrrP <br /> 3 hnWpsd gemnam faew or existing rite) 38— permtttu!aS.Tes <br /> 3.1 Change u'acreagu(-) .._.� aorea <br /> 3.2 1 nut acreage in Perttlit area _38 _ s 1 <br /> NORTH LA POUDRE RESOURCE Page-46- <br />