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CERTIFICATION <br />The Applicant, Fremont Paving & Redi-Mix Inc. ( <br />pr <br />by John P. Ary (print representative's name), as President <br />representative's title), does hereby certify that C e n t u r y L i n k <br />applicant/company name), <br />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 />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant V-& /bilk epresentative Name <br />Date Gf. ?CJI to Title <br />STATE OF (f.0(6/?R d ) <br />ss. <br />COUNTY OF ) <br />The forego s acknowledged before, e thi 11 day of OG Q -r 20, b <br />Oh rt V` as P res r 2A. ` of F eM a d- M. <br />pr <br />My Commission Expires: <br />Notary Public <br />STEVE CHISHOLM <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID # 20164034667 <br />M' COMMISSION SEPTEMBER 08, 2020