Laserfiche WebLink
The Applicant, Cooley & Sons Excavating, Inc. (print applicant /company name), <br />b James Cooley (print representative's name), as President (print <br />representative's title), does hereby certify that SLV REC (structure owner) shall <br />be compensated for any damage from the proposed mining operation to the above listed structure(s) <br />located on or within 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br />Permit Application for Screening /Crushing Agg. @ Pepper Recharge Pit <br />File Number M- 2011 034 <br />This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br />authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br />the Colorado Mined Land Reclamation Act for Hard Rock, Metal, and Designated Mining Operations. <br />Any alteration or modification to this form shall result in voiding this form. <br />ACKNOWLEGED BY: <br />ooley & Sons Excavatigg,Inc. <br />Applicant Representative Name <br />Date / - % " / -. Title <br />STATE OF Cti -6 <br />COUNTY OF (`& <br />The foregoing was acknowledged },fore me this ) ) day of �t, , 20 / , by <br />r%artxa LeTkr as ' Jt- - t -.; t, of � �c�c� f j/c9t,9 tVCu cz- s <br />r <br />Nota y blic <br />NOTARY FOR PERMIT APPLICANT <br />) ss. <br />CERTIFICATION <br />Preside <br />My Commission Expires: /1/0. l5 <br />(operation name), <br />