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CERTIFICATION <br /> The Applicant, Yuma County (print <br /> applicant/company name), by Don Marr (print <br /> representative's name), as Reclamation,Mining and Safety Coord. print representative's title), <br /> does hereby certify that Vernon Harding (structure <br /> owner) shall be compensated for any damage from the proposed mining operation to the above <br /> listed structure(s) located on or within 200 feet of the proposed affected area described within <br /> Exhibit A, of the Reclamation Permit Application for Crossland Pit (operation <br /> File Number M- - <br /> This form has been approved by the Colorado Mined Land Reclamation Board <br /> pursuant to its authority under the Colorado Land Reclamation Act for the Extraction of <br /> Construction Materials and the Colorado Mined Land Reclamation Act for Hard Rock, Metal, <br /> and Designated Mining Operations. Any alteration or modification to this form shall result in <br /> voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant � %p O y Representative Name `--- <br /> Date �3 1— / C' Title ikQ)4 'tiIvaW 1 A�0 S 6&TX( <br /> STATE OF -c,, ) <br /> ss. <br /> COUNTY OF ( )-, ) <br /> The foregoing was acknowledged before me this.3L day of :fi , 20 1.- , by <br /> as 11c is ti 'c,r,_t;. I�;r Of <br /> M Commission Expires: i; / ,� Notary Public <br /> y p —'A �f <br /> DEBORAH LEA LOGUE <br /> NOTARY PUBLIC-STATE OF COLORADO <br /> Notary Identification#20154045671 <br /> My Commission Expires 11/24/2019 <br />