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Receipt and Proof of Filing <br />Morton Lakes 112 Reclamation Permit Application <br />I, <br />with the Weld <br />County Commissioners Office, hereby acknowledge receipt of the <br />following: <br />• "Notice of Filing Application for Colorado Mined Land <br />Reclamation Permit" <br />• Morton Lakes 112 Reclamation Permit Application Form <br />A C_ l <br />Signature <br /> <br />J l1 <br />Date <br /> <br /> <br />1 ="r <br /> <br /> <br /> <br />?Z