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CERTIFIC�44,T]<ON <br /> The Applicant, E-470 Public Highway Authodty —(print applicanticompany name), <br /> by Neil Thomson (print representative's name),as Director Orffnpinevfng and Roadway Malnlamos(print <br /> representative's title),does hereby certify that United Water and Sanitation District(structure owner) shall <br /> be compensated for any damage from the proposed mining operation to the above listed st>iuctum(s) <br /> located on or within 200 feet of the proposed affected area described within Exhibit A,of the Reclamation <br /> Permit Application for Sandy Acres Pit (operation name), <br /> File Number M-1980_110 . <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to ks <br /> authorky under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock,Meta4 and Designated Mining Operations. <br /> Any alteration or mod(jicadon to this form shall resuk in voiding this form. <br /> NOTARY FOR XOMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant 9100 ltlx7 r. Representative Name l"C f L �{-��,py� r✓ <br /> Date r g.RvAO 76, 2vlte Title h(AZeYnrt of L-W4. SRcwpr,, �nt� <br /> STATE OF to lnrlclo ) <br /> COUNTY OFg;,) <br /> The foregoing was acknowledged before me thiscAO-day of February. ,20 J14—by <br /> "Phorn*or-% as b(ire e{o,r of_E 4 R- Awww h&SM l: <br /> &&M&2 _, My Commission Expires,. p-luml�r �t5, sots <br /> Notary Publj <br /> DIANE LUNDQUIST <br /> Notary Public <br /> state of Colorado <br />