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1 <br /> <br /> <br /> <br />AFFICAVIT OF INTEREST OWNEP.S <br />SURFACE ESTATE <br />P.pplicaticn No. <br />Subject Pr•opertyDistel Farm, T2N, R68W, Sections B, 17, Weld County, Colorado <br />STATE OF (:OLORADO ) <br />ss. <br />' COUNTY OF WELD ) <br />THE IJNOERSIGNED, being first duly sworn, states that to the best of his or <br />her knowledge the attached list is a true and accurate list of the names. <br />I addresses and the corresponding Parcel Identification Number assigned by the <br />Meld County Assessor of the owners of property (the surface estate) within <br />five hundred (500) feet of the property subject to the replication. This list <br />was compiled from the records of the Meld County Assessor, or an ownership <br />update from a title or abstract company or attorney. derived from such records, <br />or from the records of the Weld County Clerk and Recorder. The 71st compiled <br />from the records of the Meld County Assessor shall have been assembled within <br />' thirty (;10) days of the application submission date. <br />1 ~ , C~,~~.,,, <br />' The foregoing instrument was subscribed and sworn to before me this <br />~'~ day V~~~~-rte 19~~by~ , r~ nbs.~.~- ~ Q~~-~.. <br />-- <br />MITNESS my hand and official seal. <br />May Commission expires: ~~~`''~ r`slc~,.;.->., <br />.* ,,. <br />1 '-~yi~"• ~°~ 1 21Jo~5ry blic <br />wry, ~;`.... al; ~,. ;.: <br />'/~~~~/; Ili liiliil ~'1 . <br />