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CERTIFICATION <br />The Applicant, Fremont Paving & Redi-Mix Inc. <br />byJohn P. Ary <br />print applicant/company name), <br />print representative's name), as President (print <br />representative's title), does hereby certify that Black Hills Energy (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 Pueblo County Aggregate Project <br />File Number M-2016 -009. <br />operation name), <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 />ACK <br />Appli <br />Date <br />NOTARY FOR PERMIT APPLICANT <br />STATE OF LO/ 0 0 ) <br />ss. <br />COUNTY OF FIr—v- A:r ) <br />Representative Name 0kn- P. Av <br />Title <br />The foregoing was acknowledged before me thi day of G p <br />a <br />0 / by <br />Ar as Pre ,Side, of rex,4k / + X <br />My Commission Expires: Sep g 2 0R 6 <br />No Public <br />STEVE CHISHOLM <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID # 20164034667 <br />MY COMMISSION SEPTEMBER 08, 2020