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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 Greeley Water (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 Tnc. Representative Name John Warren <br /> Date April 27, 2017 Title Vice President <br /> STATE OF Columk ) <br /> ) ss. <br /> COUNTY OF I ) <br /> e oregoi wa acknowledged before me this ` da of , !j,by <br /> • as of � <br /> My Commission Expires: <br /> ry ubli <br /> =JENNIFERLINDBLADDBLADBLICORADO04029048RES FEB 2t,2018 <br />