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CERTIFICATION <br /> The Applicant, Connell Resources Inc. (print applicant/company name), <br /> by John Warren (print representative's name), as Vice President (print <br /> representative's title), does hereby certify that Sinclair Pipeline Company (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 Harmony Gardens Site (operation name), <br /> File Number M- - <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 Connell Resources Inc. Representative Name ,John warren __ <br /> Date April 27, 2017 Title Vice President <br /> STATE OF_ OAD <br /> ss. <br /> COUNTY OF ) <br /> The o e oing s o ledged b fore met 4� Way4 20 , by <br /> - ' of <br /> jW My Commission Expires: �� 4 <br /> Notary Publ c <br /> JENMFER UNDSLAD <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20004029048 <br /> MY COMMISSION EXPIRES FES 21,2018 <br />