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CERTIFICATION <br />The Permit Applicant and Mine Operator, Vesco Consulting Services, LLC by <br />hkir,ft -L 1111 hibc , as dUMh ,K , (Title) does hereby certify that <br />W 1 kh I dls 9W]e /Ma (structure owner) shall be compensated for any <br />damage from the proposed mining operation to the above listed structure(s) located on or within 200 <br />feet of the proposed affected area described within the letter attached to this agreement, of the <br />Reclamation Permit for GoodMiller #2 Pit, Permit File Number M- 2014 -070. <br />Thin form has been approved by the Colorado Mined LandReelamation Boardpursuant to its authority under the <br />Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land <br />Reclamation Act for Hard RoA Metal, and Designated Mining Operations. Any alteration or modification to this <br />form shall result in voiding this form. <br />NOTARY FOR PERMITT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant JhE&,CO Representative Name M IC&A-6'L YKVGUK <br />Date a - ��� )� Title <br />STATE OF Ci D[n ) <br />COUNTY OFl��l� ) <br />The foregoing was acknowledged before me this day of b , 20 jam, by <br />r6i 0-ba il mn, II ty as, of ut �tT--, <br />11( 6 i My Commissipn.Fxpirci : 1 -j0 •I(i <br />Notary Public <br />ARA BRISBY <br />TARY PUBLIC <br />E OF COLORADO <br />IO 0 19904004223 <br />[ENOTARY <br />N EXPIRES JANUARY 06.2019 <br />