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C2) <br /> - - CERTIFICATION <br /> The AppliTca t,Turquoise Connection <br /> (print applicant/company name), <br /> by Foster G.Scott (print representative's name),as President <br /> (print <br /> representative's title),does hereby certify that road into the Gold King On- 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 Scott Blue II <br /> (operation name), <br /> File Number M-2007-031- <br /> • <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 Adfor Hard Rock,Meta4 and DesignateeMming Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICAN <br /> ACKNOWLEGED BY: <br /> Applicant Ike TfR,0 dr;iv Ca;iv ect;cid Representative Name <br /> ofr o-51- <br /> r-4 vR , <br /> 5e4- <br /> Date <br /> GG <br /> Date 1— 2C/7 Title P.441;,-/, <br /> STATE OF b, 4.(•jo <br /> ) <br /> COUNTY OF ) <br /> 9 <br /> The foregoing was acknowledged before me this 1 day of SGPT ,2017,by 7H <br /> FOSTF/2 cs S0)-t7 as PPES t l pit T o LA I 1 A `-._• 0/0 <br /> cit C C/LC,...:(-xwit /yh+fy Commission Expires: Oa//g/ac) <br /> Notary Public <br /> r-t, OFFICIAL STAMP <br /> : <br /> .a��•> VICKI LYNN CUNNINGHAM <br /> ` � NOTARY PUBLIC-OREGON <br /> `r'" COMMISSION NO.947584 <br /> MY COMMISSION EXPIRES FEBRUARY 18,2020 <br />