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CERTIFICATION <br /> The Al-�phcl-:n- SEMA Construction, Inc. iprint�Ipplirint conlpanc none). <br /> bv Mark Brooks 1priut male~. a; District Vice President (print <br /> representative's title).does hereby certify-that Xcel Energy {structure o,vner)shall <br /> be compensated for any danla2 lion the proposed alining operation to the above listed stilicture(s) <br /> located on or within_00 feet of the proposed affected area described within Esliibit A.of the Reclamation <br /> Permit Application for Betz Borrow Pit (operation name). <br /> File Number Xl- - <br /> This form has been approved by the Colorado Mined Land Reclamation Board pars uant to its <br /> authoriy under the Colorado Land Reclamation Act for the Extraction of Construction 31aterials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock,.Metal,and Designated.11ining Operations. <br /> Anti•alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNO'N'LEGED BY: �— <br /> Applicant SEMA Constriction, Inc. Representative Name <br /> Date A,`j '�.r,-r 2a, Zdl O Title District Vice President <br /> STATE OF Colorado ) <br /> ss. <br /> COLTN'TY OFt4ra hoC. ) <br /> The forego"12 was acknowledged before ale thiab day of rd,$-1�- .2016.by <br /> Al, W. }3fook5 as DlS•rid ✓1ct PltS��f a�iort TIC. <br /> My Conmlission Expires: D Q ZD <br /> \oral~-Pu lie <br /> NANCY T GUERRERO <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 201 ZW67633 <br /> MY COMMISSION EXPIRES 10/19/2020 <br />