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<br /> <br />5. The additional stipulations set forth in the attached rider, if <br />any, are incorporated herein by reference. <br />/ X / a) Rider is attached. <br />/ / b) No rider is attached. <br />ACCEPTED AND AGREED: <br />DIVISION OF MINERALS AND GEOLOGY <br />COLORADO DEPARTMENT OF <br />NATURAL RESOURCES <br />BY t~.~~ <br />'Operator Title Division Dire t <br />STATE OF ~ )ss <br />COUNTY OF ) <br />The fore oing instrument w~,s acknowl ged before me is ~ day of <br />19 ~!3 by _ ~ , <br />as of <br />~ operator. <br />=• '•. My Commission expires: <br />~~ ~ ~,~ <br />~~~ 4~ <br />NOT Y PUBLIC <br />