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CERTIFICATION <br />The Applicant, Vesco Consulting Services, LLC, by Michael Miller, as Owner, does hereby <br />certify that AVV-bl <br />M CV y > IZ-.h (structure owner) shall be <br />compensated for any damage from the proposed mining operation to the above listed <br />structure(s) located on or within 200 feet of the proposed affected area described within <br />Exhibit A, of the Reclamation Permit Application for Goodmiller #2 Pit in Weld County <br />This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority <br />under the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado <br />Mined Land Reclamation Act for Hard Rock, Metal, and Designated Mining Operations. Any alteration or <br />modification to this form shall result in voiding this form. <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant V&.Scp Gm ul'll ojb Representative Name <br />5 6y-V t U-5 , U,(-- <br />Date IL- lit— m Title gw-K�{ <br />STATE OF Ctr�� ) <br />) ss. <br />COUNTY OF )'L(c91 U ) <br />The foregoing was acknowledged before me this I q day of , 20 A, by <br />as 1k)RDL of VtS60 I.S*(e <br />- J04jij My Commission Expires: ANGEJALARSON <br />Notary ublic NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID 20044031101 <br />My Commission Expires September 1, 2016 <br />