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CERTIFICATION <br /> The Applicant, Transit Mix Concrete Co. (print applicant/company name), <br /> by Jerald Schnabel (print representative's name), as President (print <br /> representative's title), does hereby certify that Dry Head Ranch, LLC (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 Hitch Rack Ranch Quarry (operation name), <br /> File Number M-2017-049 . <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 /> ACKNOW = _ ED BY: <br /> /' ,// Jerald Schnabel <br /> Applicant 401I_,�, _�` /yy e i . epresentative Name <br /> November 13, 2017 Title President of Transit Mix Concrete Co. <br /> Date / <br /> STATE OF Colorado ) <br /> ) ss. <br /> COUNTY OF Denver ) <br /> The foregoing was acknowledged before me this 13thday of November , 20 17,by <br /> Jerald Schnabel as President of Transit Mix Concrete Co. - <br /> 1 , <br /> ♦ � My Commission Expires: (22- 207- 1019 <br /> otary 0 lic <br /> KAY SANCHEZ 1 <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> 1 NOTARY ID 20074002949 l <br /> My Commission Expires 02-22.2019 <br />