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The Applicant, Richard F. Wyatt and Rodney B. (print applicant/company name), by Richard F. Wyatt <br />and Rodney B. /Wyatt Redi -Mix Co (print representative's name), as Richard F. Wyatt and Rodney B. <br />President and Vice- President (print representative's title), does hereby certify that Richard F. Wyatt <br />and Rodney B. Wyatt (structure owner) shall be compensated for any damage from the proposed <br />mining operation to the above listed structure(s)located on or within 200 feet of the proposed affected <br />area described within Exhibit A, of the Reclamation Permit Application for Williams/Illinois Gravel <br />Pit (operation name), File Number M- 1997_- 039. <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 />Applicant Richard F Wyatt and Rodney B. Wyatt <br />Representative Name Richard F Wyatt and Rodne�B. Wyatt <br />Date Title President and Vice - President <br />STATE OF Colorado ) <br />) ss. <br />COUNTY OF Jackson ) <br />The foregoing was acknowledged before me this day of <br />by as of <br />Commission Expires: <br />Notary Public <br />