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IIz coxsT ?r <br />7040 W. Hwy. 160 Alamos&,.Co. 81101 (718) 5896671 <br />PROOF OF DELIVERY TO COUNTY CLERK AND RECORDER <br />Received byc ? N Title Date `D <br />AFFIDAVIT <br />BE IT ACKNOWLEDGED, that Tiffany Hawkins, of Alamosa, Colorado, the undersigned <br />deponent, being of legal age, does hereby depose and say under oath as follows, I personally <br />delivered copies of the Proof of Publication and Proof of Mailings to Adjacent Landowners to be <br />added to the amended Regular Operation (112) Reclamation Permit Application form currently on <br />file with the Rio Grande County Clerk located at 965 6th Street, Annex Building Rio Grande County <br />Courthouse, Del Norte CO 81132 and requested that they retain it on file. <br />And I affirm that the foregoing is true except as to the statements made upon information and <br />belief, and as to those I believe to be true. <br />Witness my hand under the penalties of perjury this c? day ofpia rc o1 o. <br />kLm <br />Jore <br />rd?90 3 ®1® <br />M,ry?h9 Re ?a ? c <br />d Sa 03t?