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CERTIFICATION <br /> The Applicant, Loveland Ready Mix Concrete, Inc., by Brad Fancher, as Vice President, does <br /> hereby certify that Larimer County shall be compensated for any damage from the proposed <br /> mining operation to the above listed structure(s) located on or within 200 feet of the proposed <br /> affected area described within Exhibit A, of the Reclamation Permit Application for sand and <br /> gravel mining of the Knox Pit. <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 <br /> and the Colorado Mined Land Reclamation Act for Hard Rock, Metal, and Designated Mining <br /> Operations. Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Applicant: Loveland Ready Mix Concrete, Inc. <br /> Representative Name: Brad Fa. he Aillr---- ----- <br /> iiir- <br /> Representative Signature: .: �%//i'j <br /> Date: September 5, 2017 <br /> Title: Vice President <br /> STATE OF COLORADO <br /> SS: <br /> COUNTY OF LARIMER <br /> On this 5 day of September ,2017, before me personally appeared, <br /> BRAD FANCHER,known to me to be the persons whose names are subscribed to the above instrument and who <br /> acknowledged to me that they executed the same as their free act and deed. <br /> IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year in this ccittittaitisill <br /> first above written. 4,0`�endY S °/♦ <br /> ,,,,,Z$441‘ <br /> ♦ <br /> MY COMMISSION EXPIRES: October 4,2019 Witness my hand and official sial. % �® <br /> �,C�Q� S'ati,. .. 0 0� <br /> y • <br /> ® : <br />