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CERTIFICATION <br /> The Applicant, Yuma County (print <br /> applicant/company name), by Don Marr (print representative's <br /> name), as Reclamation,Mining and Safety Coord. (print <br /> representative's title), does hereby certify that Highline Electric (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 Crossland Pit (operation name), <br /> File Number M- - <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 /> Applicant L i vwt A Cc U Representative Name - <br /> Date ZS '3 -Zo Title rc1A n <br /> STATE OF <br /> ss. <br /> COUNTY OF t i a- ) <br /> The foregoing was acknowledged before me this_JL�Lday of . i , 20 I G� , by <br /> r� t11Ci�-� as t2_: j Q),o k ,; of { 1,(r7� <br /> My Commission Expires: /Z21 <br /> Notary Public <br /> DEBORAH LEA LOGUE <br /> NOTARY PUBLIC-STATE OF COLORADO <br /> Notary Identification#20154045671 <br /> My Commission Expires 11/24/2019 <br />