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• <br />AFFIDAVIT <br />• ffiIBIT Q <br />ffiIBIT R <br />SE IT ACKNOWLEDGED, the+. Todd A. Stockebrand of Alamosa, Colorado, the <br />undersigned deponent, be?ng of legal age, does hereby depose and say under oath as <br />follows: I personally delivered a copy of the Regular Operation (112) Reclamation Permit <br />Application form complete with all exhibits to the Costilla County Clerk and Recorder at <br />382 Main Street, San Luis, CO, and requested that they retain it on file for no less than 6 <br />months unless notified othervvise. <br />7 also personally delivered copies of the Application Form to the Costilla County <br />Commissioners Office, and the Soil Conservation District Office in San Luis, CO. <br />And 1 affirm that the foregoing is true except as to statements made upon <br />information and belief, and as to those 1 believe them to be true. <br />Witness my hand under the penalties of perjury this 24th day of September, 1997. <br />Signature <br />4435 Road 9 South <br />STATE OF Colorado <br />COUNTY OF Alamosa <br />Alamosa, CO 81101 <br />On September 24, 1996 before me, Todd A. Stockebrand personally appeared, <br />personally known to me to be the person whose name is subscribed to the within <br />instrument and acknowledged to me that he executed the same in his authorized <br />capacity, and that by his signature on the instrument the person, or the entity upon <br />behalf of which the person acted, executed the instrument. <br />WITNESS my hand and official seal. <br />i' <br />Signature <br />Susan King <br />My Comn~~ssion expires /`a 5-97 <br />(Seal) <br />Page 1 <br />