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3hc Applicant. 1..gZt) _ 8 ar Lan f--CC&4f pda applic arWcompany name), <br />by }_q�c ILA't —(pft np==ative'$=wl es Manager (print <br />representaws tidal does hereby certify that -' CF - - ct ►N-,- (Wuct= owner) shall <br />be compensated for my damage from the proposed mining operation to the above listed somctur+e(s) <br />located on or within 200 feet of the proposed affected area de= -bed within Exhibit A, of the Reclamation <br />Permit Appli cWon for Uncompahgre Pit <br />(operation name), <br />File Number M -?Al3 --007. <br />TA* force baa baw qWorW by rke Colorado MiM4 Land RodawAWbn Bowdpw==1 to hr <br />www"IlwrMl y carder the Celasa& Land Redawadm Adfor the Rv&wcdM ofCaas &Mcdon Materials and <br />the Colorado Mid Land Rey A=ja im Ad far Hard RwA Mew and DesWsW Mirrheg opa„d*v= <br />Any aJtendon ormodrea&x to thisforrx shall M&* v0&W thas foray <br />PI) PT-5W70 <br />ACKNOWLECED BY: <br />ApplicantE wty k [3G,rLar/ ��c ft,� P Lce U.t� A R,epcesentative Name <br />Date Aebttg& /.I 'title firs v1 <br />STATE OF CD t.0kA DO ) <br />COUNTY OF "O�f2pg� <br />'17M foregoing was acl mwlex W before me: this 17- day of FweqAz, 20 r5 by <br />ion Expires:_ <br />