SURFACE LANDOWNER'S CONSENT

I, , CERTIFY that I hold surface rights on the following lands on which holds mineral estate rights:

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County of .

I have examined the mining plans and reclamation plan prepared by in compliance with the Wyoming ENVIRONMENTAL QUALITY ACT, and do hereby approve said plans, and give my consent to enter and carry out said mining and reclamation programs on said lands as proposed therein.

Dated this day of ,

Surface Landowner Name