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I GI'V viz <br /> CERTIFICATION <br /> The Applicant, Schmidt Construction Company, by Scott Davis, as Vice-President of Schmidt <br /> Construction Company, does hereby certify that Cci/ �p kAic, <br /> (print structure owner) <br /> shall be compensated for any damage from the proposed mining operation to the above listed <br /> structure(s) located on or within 200 feet of the proposed affected area as defined in the Miller <br /> Gravel Pit (M-1982-112) permit documents. The map included in "Exhibit A-sa" of this document <br /> shows the approximate locations of all structures listed above as of February 5, 2018 when these <br /> structures were identified on site. <br /> NOTARY FOR PROSPECTIVE SUCCESSOR <br /> ACKNOWLEDGED BY: <br /> Successor: Schmidt Construction Company Representative Namefo. .•��' <br /> Date �a Title <br /> STATE OF COLORADO ) <br /> COUNTY OF E I P6 17 ) ss. <br /> The foregoing was acknowledged before me this OO" •d day of pbrua f J , 20 , by <br /> CiO1 l *Win G as l Ce P G(d` ±— of //1/11/d� COIA-Stikei <br /> InAN <br /> V V A iI ASI A I,/ My Commission Expires AQ/ <br /> 4 't Notary Public <br /> fr-::"':a•?.IER VHITTINGTON <br /> ),:R(PUBLIC <br /> COLORADO <br /> 200b4022664 <br /> mfris rr P p;re P;302O2' <br />