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-2- <br />This form has been approved by the Mined Land Reclamation Board pursuant to sections 34-32-119, C.R.S., of the <br />Mined Land Reclamation Act and 34-32.5-119, C.R.S, of the Colorado Land Reclamation Act for the Extraction of <br />Construction Materials. Any alteration or modification of this form shall result in voiding any permit issued on the <br />altered or modified form and subject the operator to cease and desist orders and civil penalties for operating without a <br />permit pursuant to sections 34-32-123, C.R.S., of the Mined Land Reclamation Act and 34-32.5-123, C.R.S., of the <br />Colorado Land Reclamation Act for the Extraction of Construction Materials. <br />Applicant and Successor hereby request the State to consent to the assignment ofthe approved Permit Application <br />to recognize the Successor as the approved Applicant under the permitting process. <br />C <br />I ?? ?C?fZ-Q /G??Y ?• .7143rii1?t? 6001 yrrntes? <br />11(//,25x• L.o??O <br />Name of Perini App 'cant Name of Successor Applicant <br />f,W K <br />9' -!6 -/o <br />By By <br />Signature of Officer S' a ure of fficer <br />{e S el(.e 0, f 4e ?rc5?o1? 7` <br />Title of Officer Title of Officer <br />NOTARY FOR PERMIT APPLICANT <br />STATE OF ?Q (OCz?A-?O ) <br />) ss. <br />COUNTY OF LA ) <br />The foregoing instrument was acknowledged before me this 4 day of by <br />1 D A =saz- as QPS>n>?$I' of <br />ARY U IC p LL <br />..PkY.. <br />My Commission expires: ?? -` - <br />O - <br />NOTARY FOR SUCCESSOR APPLICANT V <br />STATE OF <br />ss. , //"91, <br />OF G % <br />COUNTY OF <br />The foregoing instrument was acknowledged b fore this JV day of ?I a l!S f o? y 10 by <br />f `7 S_; e! fK-4tn? as 'fle5i of a P S(t) 61ot? r`? c dSa (,Cry; FP U <br />P4 ""'••• e?i NOTARY PUBLIC C <br />My Commission expires: c) O q-l?-l6 <br />r. _N A <br />'• Iv.. BLE ;? o <br />f qlf OF GG?'???