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CERTMCATION <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 Boat d pursuant to its authority tinder <br /> the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land <br /> Reclamation Act for Hard Rock Metal,and Designated Illlning Operations Any alteration or modification to <br /> thisform shall result in voiding this form. <br /> R go <br /> PLIC_ , <br /> ACKNOWLEGED BY; ` <br /> Applicant ELA M C0N.3T -r)v_Representative Name <br /> Date , Z 4 • 201 to Title C(p' INAc-MP_ <br /> STATE OF <br /> }ss. <br /> COUNTY OF f S,-A- } <br /> 4— <br /> The foregoing was acknowledged before me this day of l 20 Ro,by <br /> ,�"L(lr► '� Mue{fir as�a"t0tCOnme(4Z1 of Glaa\ O/10r'uO0-' ' . <br /> C�rn(�llance.. c��ni✓ k� <br /> ( - le) 1 <br /> � My Commission Expires: �j <br /> Notary Public <br /> KAREN BINDER <br /> Notary Pvbk <br /> State of Colorado <br /> Notary 10 20154047528 <br /> My Commission Exelres Dec 10, 2018 <br />