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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 S t. C h a r 1 e s M e s a ( <br />structure owner) shall <br />Water ntstrict <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 9016 -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 />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant Fre " Representative Name <br />Date to// 7/1 6 <br />STATE OF CO (o lam/( 0 ) <br />ss. <br />COUNTY OF Fre war ) <br />Title PPeSldeA <br />The foregoing w s acknowledged before me this lay of Cc4e F 20 1K, jy <br />o%r\ Ar as ( S IQIQA-r of r/,elv * aJ hqg- AdI <br />My Commission Expires: 26,26 <br />Notary Public <br />STEVE CHISHOLM <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID # 20164034667 <br />MY COMMISSION SEPTEMBER 08, 2020