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CERTIFICATION <br />The Applicant, Las Animas County (print applicant /company name), <br />by Gary D. Hill (print representatives name), as Commission Board Chairman (pmt <br />representative's title), does hereby certify that Daniel Peacock (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 <br />File Number M- M— 4P Maya Pit <br />(operation name), <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 Operation& <br />Any alteration or modification to this form shall result in voiding this form. <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant L� t� /�,L� Cic,/enX Repro <br />Date 0a,- I9 -DClq Title <br />STATE OF O C f,,AO ) <br />) ss. <br />COUNTY OF Lr45 Any vKm ) <br />The foregoing was acknowledged before me this day of j=f =-BR Ltq y , 20 I� , by <br />as �a w .h of Ui AvtilMAg Ludy l��trd.a�' (oY►�rNissiMers <br />"ki Lb . ( My Commission Expires: <br />of Public <br />11 <br />CNq VFZ 4. <br />to <br />C) <br />o�y�s OF COLORP�O o`a <br />�iON EXPIRES 061o3�2 <br />