PERMFILE47226

• Permit No: M1992009
• IBM Index Class Name: Permit File
• Doc Date: 1/28/1992
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

-5-
4. I understand that statements in the application are being made under penalty
of perjury and that false statements made herein are punishable as a Class 1
misdemeanor pursuant to Section 18-8-503, C.R.S.
Signed and dated this 27
day of January
Applicant/0 erator 77
By: -
71 t l
State of Colorado )
Denver ) ss.
County of )
The f going n r ent 6 acknowledged
by as
Corporate Secretary or Equivalent
Town/City/County Clerk
me th i s ~ day of ~ , _1.1gc Z
~_ of ~es ~ v~
Public
My Commission Expires:
(08/91) 2823E
1992
(Gillett Sand & Gravel)
If Corporation Attest (Seal)
By:
My Commission Expires
Ma 4, 7993
13795 y 16th Drive
Golden, co eoao7
..