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CERTIFICATION <br /> The Applicant, Van Valkenburg Cattle Co., LLC (print applicant/company name). <br /> bvWilliam Van Valkenburg (print representative's name), as Manager (print <br /> representative's title), does hereby certify that Jackson County Road & Bridge (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 Van Valkenburg Quarry (operation name). <br /> File Number M-a016 -0133 <br /> This form has heen approved by the Colorado illined Land Reclamation Board pursuant to its <br /> authority under the Colorado Land Reclamation Act for the Extraction of Construction lblaterials and <br /> the Colorado Alined Land Reclamation Act for Hard Rock,Aletal, and Designated Alining 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 UL � presentative Name }� <br /> Van Valkenburg Cattle Co.,� William Van Valkenburg <br /> Date ), l L1 5'u , 2-c-)i to Title C ,�C LI I acic►Z, <br /> J <br /> STATE OF(t ��( (-L \( ; ) <br /> ss. <br /> COUNTY OF�y�C�CSGtI� ) <br /> e fore- in- as eknowledged before me this&W day of-&I , 20�, y <br /> b� as �(4�� LZ� of Q «L' <br /> � - o <br /> W11 My Commission Expires: <br /> otary Puqjc <br />