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LERTiFxCATION <br />lU Applicant, -ag K i3 sr � a r A 4- �.Qt.- -_ - e. W prittt applirant/com Y name), <br />by_ *w rep we ntative's name), aaManager __.(pritrt <br />tepam e's title). does hereby autify that % (structure owner) shall <br />be cxxnperisatsd for airy damage Isom the proposed rr hft operation to the above listed str mur (s) <br />located on or within 200 feet. of the proposed affected area described within Exhibit A, of the Reclamation <br />Permit Apptiestion for Uncompahgre pit <br />File Number M- 2013- -007, <br />(operation name), <br />T" fWM Ares bwn approved by #e Cuba do M&red Land Rodawetim Boats pw=mzW to fa <br />aerdiority undar dire Colorado Land Reclamwimt Act for dke F.x&wcdon of Conat"Wdon Metvia& and <br />die Cakr adoAfinedLandRodamdfonActforHwd ,Rock,Ve* andDes4psa&dMW 0PpA*0jm <br />'"y OrfiW4J?cadmr to tftforw shall resrrltin wd&V this fa-7a <br />NOTARY FOR PERMIT APYLI _ T <br />ACKNOWLIMED SY: <br />Applicant hZIM 'C+ I Repreaenrative Name <br />Date O liG,- ;/(;2 _� n (� TWO <br />STATE OF COLDe -ADO ) <br />ss. <br />COUNTY OF 1" (ON I RO <br />The foregoing was acknowledged before = this 17— day of _ 20 5 try <br />IAIA �' - em: i. f � 11�... .f of BA9 LAW D C6T 1Lf, CO i t I? <br />Expires: t!4 2-011, <br />DMEM A. ; . <br />CHEZEM <br />s <br />