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CERTIFICATION <br /> The Applicant, Arnolds Custom Seeding LLC (print applicant/company name), <br /> by Rick Gillan (print representative's name), as Vice President (print <br /> representative's title), does hereby certify that Morgan County REA (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 Arnold Pit No. 1 (operation name), <br /> File Number M- 2016 022 <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 /> Applicantkfqw ( 1�Cy ��� lq Representative Name <br /> Date s hq) 1� Title <br /> STATE OF CO I o r ot d D ) <br /> ss. <br /> COUNTY OF Oytam s ) <br /> e fore oing was acknowledged befor me this q day of , 20/gyp, by <br /> 1G14 l l k n asl�_C0 yre-,Std-w'1�' of of/1 l Cif. -U?Y1 Q <br /> C' GL PODI_� My Commission Expires: <br /> Notary Public <br /> M MONICA POOLE <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20064049340 <br /> my C,,(}1v MISSION EXPIRES FEBRUARY 27,201 <br />