PERMFILE103529

• Permit No: M2005066
• IBM Index Class Name: Permit File
• Doc Date: 10/13/2005
• Doc Name: Reclamation Permit Application Form
• From: Asphalt Paving Company
• To: DMG
• Media Type: D
• Archive: No

AFFIDAVIT OF RECEIPT
This document holds that the Weld County Clerk to the Board's office has received a
copy of the "Colorado Mined Land Reclamation Board Application for Construction
Materials Regular 112 Reclamation Permit, Wattenberg West Sand and Gravel Mine and
Water Storage Project, Weld County, Colorado", dated October 11, 2005.
Dated this/~~~ , 2005.
Weld Co my Clerk to the Board