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CERTIFICATION <br />The Applicant, Yuma Count _(print applicant/company name), <br />by Howard McGinnis (print representative's name), as Truck and Mining Foreman (print <br />representative's title), does hereby certify that Brandi Mann (structure owner) shall <br />be compensated for any damage from the proposed mining operation to the above listed structure(s) <br />located on or within 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br />Permit Application for Moser Pit (operation name), <br />File Number M- 2008 -035 <br />This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br />authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br />the Colorado Mined Land Reclamation Act far Hard Rock, Metal, and Designated Mining Operations. <br />Any alteration or modification to this form shall result in voiding this form. <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant ltla4lw C vgoil– /Zo (J� Iepresentative Name <br />Date Z ` 17 fo/ 5 Title % Puc% A,ve� �Iir�ori -o Iced <br />STATE OF � -o,coo _ ) <br />ss, <br />COUNTY OF `` Wc— , ) <br />e foregoing was acknowledged before me thisV-1 day of hs��r , 20\5, by <br />wc�r� C�����rn� as ��uc t yYl,r r �re�c�Of W"n <br />M:y Commission Expires: L � ', <br />N ry Publ <br />