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.
r) / Date:
By: - t --
Eric-R, Recke ine
Area Manager Northern `Colorado Aggregate.Division
State of Colorado
ss.
County of )
The foregoing instniment was acknowledged before nie this . day of
20 `? . by Erie R. Reckentine as Area Manager Northern Colorado.
Wgegate Division of Lafarge West, Inc.
r
Commission Expires:
Notary Publi L y y
OF G
Structure Owner
Date:
Structure:Owrer Signature.
State of Colorado
} ss.
County of }
The foregoing instrument was acknowledged before me this day of
20 , by'
As of
My Commission. Ekpires:
Notary,Public
VA.137 029J)ocUmrnts'.Adjxefu StructumtSirmum O?rn r Agn-c=msiformdoc
Page 2 of 2
Agreement to Mine Within 200 Feet of Permanent Manmade Structures
Lafarge West, Inc./Tigges Oil LLC