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CERTIFICATION <br />The Applicant_ TONY J. BELTRAMO AND SONS, INC. (print apphcanticompany name). <br />by ROBERT D. BELTRAMO (pmt representative's name)_ as PRESIDENT (print <br />representative's title'. does hereby certify that MR. CESAR (structure owner) shall <br />be compensated for any damage from the proposed mining operation to the above listed structures) <br />located on or within 200 feet of the proposed affected area described within Exhibit k of the Reclamation <br />permit Application for CESAR 111 BORROW PIT (operation name). <br />File Number M _ <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 .4ct 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'Itny J Ee1tray P d Si, In. Representative Name <br />Date 11 11 J,1 p'3 <br />STATE OF Oakrab <br />) ss. <br />COUNTY OF RENO <br />Title ThE iL rt <br />/7/4-7.3.) <br />iL <br />The foregoing was acknowledged before me this I day of %1GUy..,tist -• . _2013. by <br />Int D Belt[aro as Pit itiat . <br />of Public jareke Thcrszn <br />oPibny J Belttata Prtd Sas, Inc. <br />My Commission Expires: 05/09/2014 <br />