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Nov.22.2016 09:41 AM MCCORMICK EXCAVATION a PA 7193485363 PAGE. 3/ 4 <br /> CIMIDICATION <br /> The Appiicank CO C +n'� t`g j F I% e f&u(. 1-cy, ,y „( W$PPlic wW0ou*mgy nsme� <br /> by.�QraIQsM�'CfYrrt+�i .�(luhitn e�stiveisname},sa ,mu.ncs: ..,8s r�,.L. .''.__.._.(pit <br /> r eP POeD fitiVe's t9),dm 1 ccr*dW .N Ins R n( 00 ,Q <br /> be oo®peosatad for any damage from the PraPowd mining operation to tie Above hued re(s) <br /> located on or within 200 hd ofthe proposed Affoead Ana described wittrtn Exhibit A4 of the won <br /> Permit Application for (apnradon nAMN <br /> Fila W=bw?Q& <br /> rkfdwm hm how appron4 by sAw Ca MjnLMj j4 dReel'sarardear aevdjv,,r8m,4fw to itr <br /> sue►MA&r or Cforrdo Lerut Ad far the diva ojC1oar M awd <br /> s.Co s Miaadlm�.+ ra�faa Ad,trHmW Rat MmW AmdA dAfigb#g.qwAdma: <br /> . lmy shwedn or to dds f&v=shard r sa*he voiabg dt is fwm <br /> NOTARY FOR PERM AMULW <br /> ACKMWLEOM BY: <br /> A►ppliemtll`Cty rn awl P.1 Z.On Mative W7- <br /> , <br /> Dee - `�► l 'Title Mn03uh ice- <br /> STATE. t�cK o } <br /> C=fff off . ,n <br /> The 6omgaing was mctaawtcdged before this "•day of <br /> 20 by► r <br /> �) i ("('�1� .1C,f• w� ��jLIL�I� of We <br /> NouWftMk <br /> STATE o►co�oMoo <br /> ttOTARY 10•1N74®t0�if j <br />