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CERT.LFICATiON <br />The Applicant, L .K, 8 car Land d- Cad l e�fprint applicanveom� ww name), <br />by I mpcesentativc's a$Manege�' (Print <br />J <br />cept+esea�tive'3 fi ft does hemby certify that 4 ., pfd owner) shah <br />be compensated for any damage from the proposed mining operation to the above listed "Icture(s) <br />toed on or within 2W feet of the proposed affected area described within Exhibit A, of the Reclamation <br />Permit Appi"mation for Uncompahgre Pit <br />File Number wn_L 'z <br />(operation name), <br />This fora kas been approvd by Me Colorado Mined Land Redamaden .board pnev mntW Us <br />asdkority wider the Colorado Land Ratama*0" Actfor rite Eaftudgn of Cons on Meta" and <br />tine Colorado MImW Lana Redamadw Act fear Hard .Rods; Md4 and Designated MIft Operas enz <br />At{y altesation or mod M to obis form skaQ rean& in voiding tkis form. <br />ACKNOWLEGED BY: <br />f C z Cam Co II Rive Name <br />Applicant '� �r ��— <br />Date rG,6a A r U,_ 12 gro /.:�L_ — Title <br />STATE OF C.OL R2ADO ) <br />COUNTY OF t" OWIWS$l <br />The foregoing was ackwwledged before me this 12 day of R � , 20JS by , <br />J�Fy JU T"f <br />--as C2WEgAl - �P t_ �cf P-CR -Lf- GD 111 <br />Expires: 1 j � 1 Za r <br />