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CER !CATION <br />The App:icfuit,-Parkcrson Construction, Inc <br />(Mita[ applicantJccn:ipany nanie). <br />by Alan Par-kersort (printrepresentativc's name', as Vice ProSiclent <br />brint <br />rvpresentative's otic?: does lreby certii that Rio Blanco County <br />(structure ; .kiei )shall <br />be comet nsaled for any dantaae from the proposed ruining ops ?nicht to the rihove lister :"tructurti(5} <br />iocated on or within 700 feet of the proDesed affected min de crihcii within 1:xhibil ,A, o the kuctar axion <br />Permit nit Iiearion lr.�r East Douglas Pit <br />p — , Operatlot) Ffaint:), <br />!'i;c Number ;11- 1987 1©3 <br />Phis form has bean approved by the Colorado Mined Lund Reclamation Board pursuar:t to its <br />authority under the Colorado Land Reclamation Act for the EA -traction of Consttaction Materials and <br />the Colorado Mined fund Reclamation .Adfor Hard Rock, Metal, and DesignatedMining Operations. <br />Any alteration or inociffication to this' form shah result in voiding this form. <br />NOTARY FOR PERMITAJ'PLJCANT <br />ACIGNOWLEGFD 13Y <br />_ �f <br />pplicant e �'.l3�:.nx.�-r Rcpresentat]ve • VIaIne _ 0" P411-Ccanf vfi-- <br />D, to b Ce4-... 3:e_f , -C i <br />STATE OP Col es'0. t) <br />hT <br />/ t /� ) ss_ <br />COUNTY O1` J���.c,(_Z, •} <br />Title A --L4-41 A4-, ; t 2 �24AJ <br />The foiego ing was aclaiowled:#;c:cd before me this and day of 12; ' 20 1S, by <br />is !(.1.(1 Par1: _ e_rE-D 1 aR \J1`3 <br />OE P[.ilf.'_e"r� ,mn Cry„l£tti..ta-lil3no - <br />L CL tr"t f ?vly Commission L:xpires:i� �r i L� <br />Nota!tIrbile <br />LAURA L HARTMAN <br />Notary Public <br />State of Colorado <br />Notary ID 19994021447 <br />My Commission Expires Aug 3, 2019 <br />