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CERTIFICATION <br />The Applicant. 5edQr Land Ventures (print applicant/company name). <br />by Chris Serhousek (print representative's name), as President (print <br />representative's title), does hereby certify that Sinclair R+pell Company (sgcp re ow�nler) shall <br />be compensated for ani damage from the proposed minim opeprabon Ao t��e a ove If cl�urk(s� <br />located on or %vithin 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br />Permit Application for Harmony Windsor Site <br />File Number M- - <br />(operation name), <br />This form Inas been approred 031 the Colorado Mined Land Reclamation Board pntrsumu to its <br />authoriti, under the Colorado Land Reclamation Act for the Extraction of Co►trtruction Materials and <br />the Colorado Mined Laird Reclamation Act far Hard Rock, Metal, and Designated Mining Operations. <br />Anti alteration or modification to this form shall result in voiding this form. <br />VOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant _Serfer Tanei ventures Representative Name <br />Date Nov 15, 2017 <br />STATE 01= ao ) <br />%) ss. <br />COUNTY OF ) <br />Title Chris Serbouse'kN4Minq Member <br />Che foreemng, has acknowledged b re mp is 1 day ofNt 20'by <br />a5 j of ire <br />�Jr <br />_ l.# � My Commission Expires: <br />Notary Public <br />IENNIFER LINDEN , <br />1VDT?RY PUBL,C <br />STATE OF COLOnAr"' <br />M OTARY ID 2ppp4029Csc <br />MY ( 1hMISSION EXP tF.S FES 2t, 20i9 <br />