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From <br />nug .31 cuic 1c:cz1rM hr LHbtKJtI rHX <br />State of Colorado <br />County of Weld <br />09/04/2012 10:05 <br />JUj - bbe - b'/bb <br />#131 P.001 /001 <br />P.4 <br />AFFIDAVIT OF RECEIPT V;f�i <br />BEFORP , a r sentative of the Longmont Conservation District, on this <br />day of 20 /L, I did receive a copy of a revised "]Notice of Filing <br />Application forlColorado Mined Land Reclamation Permit for Regular (112) <br />Construction Materials Extraction Operation Turnpike Mining Resource". <br />�Signature 4-4 <br />�u a_41� � <br />Name (p inted) <br />Title (printed) --_ <br />