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-3- <br />The provisions hereof shall bind and inure to the benefit of the parties hereto and their successors <br />and assigns. <br />SIGNED, SEALED AND DATED this day of , <br />Bent County (SEALI <br />Permittee <br />By: <br />Title: <br />NOTARIZATION OF PERMITTEE'S ACKNOWLEDGEMENT <br />STATE OF ) <br />ss. <br />COUNTY OF 1 <br />The foregoing instrument was aclmowledged before me this day of , by <br />as of <br />NOTARY PUBLIC <br />My Commission expires: <br />APPROVED: <br />State of Colorado <br />Mined Land Reclamation Boazd <br />Division of Minerals and Geology <br />By: Date: <br />Division Director <br />