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A <br />a <br />CERTIFICATION <br />The Permit Applicant and Mine Operator, Vesco Consulting Services, LLC by <br />Aki(l kGz. M 1Uk#<- , as lTLtj141K , (Title) does hereby certify that <br />W M t AJ5 2LzC -21( 3. Z. (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 />This form has been approved by the Colorado Mined Land Reclamation Board pursuant 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 Rock, Metal, and Designated Mining Operations. Any alteration or modification to this <br />form shall result in voiding this form. <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant ASCO Representative Name I ►` L H-A-6-L ftL4,Wc <br />Date ;-&-) Title G.t K4C <br />STATE OF "7Qdn ) <br />) ss. <br />COUNTY OF ILIA ) <br />The foregoing was acknowledged before me this day of k In , 20 jam, by <br />r t v W. r. NEW, NOW <br />'SM(r2D� i, " I My Commission Expires: <br />Notary Public <br />TARA BRISBY <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID # 19984004223 <br />MY COMMISSION EXPIRES JANUARY 06 . 2019 <br />