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CERTIFICATION <br /> The Permitee,Elam Construction,Inc.,as Operator,does hereby certify that Public Service <br /> Company of Colorado shall be compensated for any damage from the proposed mining operation <br /> to the above listed structure(s)located on or within 200 feet of the proposed affected area <br /> described within the letter attached to this agreement,of the Reclamation Permit for the 5 Mile <br /> Pit,Permit File Number M-2016-026 <br /> This form has been approved by the Colorado Mined Land Reclamation Board pitrsuani to its authority tinder <br /> the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land <br /> Reclamation Acl for Hard Rock klelal,and Designated Afning Operatiotu Any alteration or modification to <br /> this fonn shall result in voiding this form. <br /> NOTARY FOR PEIRMrr A.PELICANr <br /> ACKNOWLEGED BY: ` <br /> Applicant ELgM CON STRuC_rVA Representative Name _�ct�n.tKA� MQG"rt_ <br /> Date �-)F,, • Z 4 - 201(c Title EtAl IR.i)r`tttQNiA!_. Lt:>WLtAK)CE C0cQDINA TDP- <br /> STATE OF. <br /> 5S. <br /> COUNTY OF <br /> The foregoing was acknowledged before me this day of t4�j-20(�,,by <br /> r n 1 O�Skur' (YN C - <br /> a(;�c�.��c' lUi�.cc°(it as 1v�► t) 1�� ,..of �1�FT'� . � <br /> J C�m(�Itanc�� C�rc%tin� <br /> �, �" (. My Commission Expires: <br /> Notary Public <br /> KAREN SINM <br /> Notary Publlc <br /> State of Colorado <br /> Notary ID 20154047528 <br /> My Commission Expires Dec 1]2019 <br />