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-3- <br />The provisions hereof shall bind and inure to the benefit of the parties hereto and their <br />successors and assigns. <br />SIGNED, SEALED AND DATED this day of , <br />Baca County (SEAL) <br />Permittee <br />By: <br />Title: <br />NOTARIZATION OF PERMITTEE'S ACKNOWLEDGEMENT <br />STATE OF ) <br />ss. <br />COUNTY OF ) <br />The foregoing instrument was acknowledged before me this day of , _, by <br />as of <br />NOTARY PUBLIC <br />My Commission expires: <br />APPROVED: <br />State of Colorado <br />Mined Land Reclamation Board <br />Division of Minerals and Geology <br />By: <br />Division Director <br />Date: <br />M:\OSS\TDDVempV.1-AP-21 M2003019_P.1W_20030415 21350 PM.doc <br />