2009-10-16_PERMIT FILE - M2009082 ‎(26)‎

• Permit No: M2009082
• IBM Index Class Name: PERMIT FILE
• Doc Date: 10/16/2009
• Doc Name: Ex. S- Perm. Man-made Structures w/i 200'
• From: Lafarge West, Inc.
• To: DRMS
• Media Type: D
• Archive: No

The parties hereto acknowledge and agree to the above-stated items.
AGREED:
Lafarge West, Inc.
By: C- - --?C -- .. .Date:
Eric R. Recke ine
Area Manager Northern Colorado Aggregate Division
-State of Colorado 1
{ } ss,
County of
The foregoing instrument was acknovciledged before the this 3 day of
20?, by Eric R. Re-c' kentine as Area Manager Northern Colorado
Ag'r gate Division of Lafarge West, Inc.
r,
y Commission Expires: - O ?OTAf? ?p
(P '01j l?G Qa
Notary Public pF COQ p?
Structu"re Owner
Structure Owner Signature
State of Colorado,
ss
County of
Date:
The foregoing 'instrument was acknowledged before me this day of
,20 ,by
as of
My Commission Expires:.
Notary.Public.
R:%4,117 4?9tDocumcgtslAdjaftm Stmetui SInw.wrc'Owner Agrct tslTigy+es Agmtt.dpc
Page 2 of 2
Agreement to Mine Within 200 Feet of Permanent Manmade Structures
Lafarge West, IncJMary M.. Tigges