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CERTIFICATION <br /> The Applicant, Western Slope Materials LLC, by Sean Mello, as General Manager, does <br /> hereby certify that 'jj�,r�s% �J `D, r c.6 Co M p A a Y (structure owner) shall be <br /> compensated for any damage from the proposed mining operation to the above listed <br /> structure(s) located on or within 200 feet of the proposed affected area described within <br /> Exhibit A, of the Reclamation Permit Application for Blue Pit, File Number M-1981-207. <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority <br /> under the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado <br /> Mined Land Reclamation Act for Hard Rock, Metal, and Designated Mining Operations.Any alteration or <br /> modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> L'-Ye S'T%n' S o iR <br /> F?r R «cJ <br /> Applicant L L e- Representative Name S t A-A) ``"' e- L 0 <br /> Date (� I1 ( !� Title CT(E 0 is (LPL_ �-k A-a-tom 6 �— <br /> STATE OF G Ia� ) <br /> TIMOTHY OLK <br /> COUNTY OF ss. Notary Public <br /> State of Colorado <br /> Notary ID it 20164038408 <br /> My Commission Expires 10-06-2020 <br /> The foregoing was acknowledged before me this I day of Nv,rc.•tib�r , 20 /6 , by <br /> P-\,_�L L.o as ��a cah` NtaNE�beti4of (,t�E> :fM1� S LLB <br /> l.o P � Vu,L-rc�ti��LS <br /> My Commission Expires: !v 6 20 <br /> Notary Public <br />