_REVISION - M1974052 ‎(12)‎

• Permit No: M1974052
• IBM Index Class Name: Revision
• Doc Name: SOLID WASTE DISPOSAL SITES USE BY SPECIAL REVIEW APPLICATION
• Type & Sequence: TR1
• Media Type: D
• Archive: No

SOL.. ..,,.,i� viar AL SITES
• AFFIDAVIT OF INTEREST OWNERS
MINERALS AND/OR SUBSURFACE ESTATE
Legal Description: NW 1/4 Section 31 . TIN, R67w.
THE UNDERSIGNED, being first duly sworn, states that to the best of his or her knowledge the attached list
is a true and accurate list of the names and addresses of all mineral owners and lessees of mineral owners
on or under the parcel of land under as their names appear upon the records in the Weld County Clerk and
Recorder's Office or from an ownership update from a title or abstract company or an attorney.
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