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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 *ccel Energy (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: 1 <br /> Applicant&no�k Representative Name �IG�( �i\��6i ti <br /> Date �/ A b Title VxIL <br /> STATE OF r d O ) <br /> ) ss. <br /> COUNTY OF Qd a4-yaS ) <br /> ACA <br /> foregoing was acknowledged before jme this day of , 20 j by <br /> / �Q,f1 as W e,o f 1--OZLdLU of urpotdz (''LLWm <br /> Cana. ca P02DL42 My Commission Expires: <br /> Notary Public <br /> MONICA POOLE <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20064049340 <br /> MY COMMISSION EXPIRES FEBRUARY 27,201 <br />