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►�2l��l005� <br /> CERTIFICATION <br /> The Applicant, Russell Larsen, Kilgore Companies, LLC dba Elam Construction (print applicant/company name), <br /> by Russell A. Larsen (print representative's name), as Chief Operating Officer (print <br /> representative's title), does hereby certify that A & G Partnership, LLLP (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 C Road Pit (operation name), <br /> File Number M-2016-050 . <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 PEWIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant 4_ PLC 0&c(OMAw1&,ILC IL1RM Representative Name R v.S 5&,L A L A 67IPA <br /> Cb�S'(euG 1T o� <br /> Date 05 Title C—0, 0 . <br /> STATE OF CO IoRA Do ) <br /> ) ss. <br /> COUNTY OF AG5A. ) <br /> The foregoing was acknowledged before me this. 1 day of MoK, , 20$, by <br /> LL,sv-(1 o y s-e.r, of 1 L r-tlb& q-Aexrcanc� <br /> My Commission Expires: l �30'ac1 <br /> Nog Nogy Public <br /> JONI PATTON <br /> Noary Pubk-Sze of Coorado <br /> Notary ID 20184005040 <br /> My Commission Expres Jan 30 2022 <br />