PERMFILE105666

• Permit No: M2005033
• IBM Index Class Name: Permit File
• Doc Date: 9/13/2006
• Doc Name: Financial and Performance Warranty Request - Constr. Material Op
• From: DRMS esc
• To: Coulson Excavating Company Inc.
• Media Type: D
• Archive: No

-3-
and assigns.
The provisions hereof shall bind and inure to the benefit of the parties hereto and their successors
SIGNED, SEALED AND DATED this day of
Coulson Excavating Co., Inc. (SEAL]
Permittee
By:
Title:
NOTARIZATION OF PERMITTEE'S ACKNOWLEDGEMENT
STATE OF 1
ss.
COUNTY OF )
The foregoing instrument was aclrnowledged before me this day of , by
as
of
NOTARY PUBLIC
My Commission expires:
APPROVED:
State of Colorado
Mined Land Reclamation Board
Division of Reclamation, Mining and Safety
By:
Date:
Division Director