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CERTIFICATION <br />The Applicant, White River City Investments (print applicant/company name), <br />by Don Silva (print representative's name), as Manager (print <br />representative's title), does hereby certify that Rio Blanco County (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 WRC Wet Pit <br />File Number M -2014- 063 <br />(operation name), <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 for 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 _ � j_ jc ( C! — Representative Name I) C) t,3 5 � [– U <br />Pr- <br />Date <br />STATE OF Plfh ) NOTARY PUBLIC <br />STATE OF COLORADO <br />D NOTARY ID #19994027723 <br />COUNTY OF Md MAM ) Commission ExpKes Oct t, 2015 <br />The foregoing was acknowledged before me this ! day of 111eur-t-, , 20/S- b <br />—� Y <br />as - _y)'<2hr11% _ - - -- of (,L,i,i�� ✓� c „cyzn ✓eJfm�,s <br />My Commission Expires: <br />Notary P blic <br />