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

SETBACK AGREEMENT
Project Name: Wallenberg West Sand and Gravel Mine
Project Location: NW Y. Section 25, T1 N, R67W, 6'" P.M., Weld County, Colorado
Applicant: Asphalt Paving Company
14802 W. 44~' Avenue, Golden, CO 80403
[phone]
Structure Owner: Western Area Power Adminisfration
PO Box 3700, Loveland, CO 80539
[phone]
The undersigned is an authorized representative of the Westem Area Power Administration. We are aware of
and understand the proposed mine and reclamation operations for the subject property (see attached "Vicinity
Map") and have talked with a representative of Asphalt Paving Company regarding these operations. We have
agreed to a setback of 37.5 feel from structures fhat we own, and do not object to the proposed operations. We
have been assured by Asphalt Paving Company that should any damage occur to our structures and
improvements due to the proposed operations, Asphalt Paving Company will fully repair any such damage at its
expense or provide full compensation for any damage.The signature of the Asphalt Paving Company officer below
and the undersigned's signature hereon confirms such agreement and repair/compensation obligation between
the parties.
Undersigned:
Western Area er Adminlst atfon
!~ ~ ' .!~/
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Title: .r.~-,3.• _~/~yl.':~i:;
STATE OF COLORADO )
)ss
COUNTY O`/~~/' /
The foregong inst1rumelnt wasya~cknowledged bef~~oppre me on t'hi 1st d/ay'of~` ,rM~n~, 20 v S by
(Name) (Title) (Company)
Witness hand and o e'ra seal.
t1~YN
tery Public
STATE OF . ~ - ~ i- ',t ~'(' )
)ss
COUNTY OFD/:.%.1,_,r~~•zr~~~.)
The foregoing"instrument was acknowled
20~y~`,. ~~ _ ,
Witness rmy hand and official seal.
l~.- fir. .
Asphalt aving Company
gy ,r ~, q ,
Ti le f • ~
r
My commission expires: L ' ~- ZOOG
.~~
ntLO.RRDIp
~ day of ~d~`.<. Zi ,
My commission expires: 7 -•R N -r, "i
Notary Public