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CERTIFICATION <br />The Applicant, Las Animas County (print applicant /company name), <br />by Gary D. Hill (print representative's name), as Commission Board Chairman (print <br />representative's title), does hereby certify that Mesa De Maya Ranch c% John Doherty (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 Mesa De Maya Pit (operation name), <br />File Number M- ""e- QP Maya Pit <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 />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant 61 it l� "6� zy Representative <br />Date - /c1- a0>y Title a i r'm <br />STATE OF 061 o r a 6c) ) <br />ss. <br />COUNTY OF Las A luim as ) <br />The fore oing was acknowledged before me this��day of F&-tAQ u , 20� by <br />A/_ 1, 1 as C�airrr,aN of LfES ANimaS Ca��rerl� l3oaizo aFCaw�•YrisSt�t�f <br />/.%�o My Commission Expires: 0 &/631,r14l <br />Notary Public <br />O,�•NRY•�.°G <br />g ChqZ q 0 Vp <br />A <br />OF COLORP� o b <br />s / °N EXPIRES oro � 2 <br />