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S7 <br />CERTIFICATION <br />The Applicant, Turkey Cation Quarry Inc., by ,4,i ► 6no n r sr =— as does hereby certify <br />that Andrew Grau (structure oxAmers) shall be compensated <br />for any damage from the proposed alining operation to the above listed stnicture(s) located within 200 feet of the <br />proposed affected area described within Exhibit A, of the Reclamation Permit for Vollmer Pit, <br />File Number M -t 983-035. <br />Signature of <br />This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority <br />larder the Colorado Laird Reclamation Act for• the F_-etraction of Consiructivil Halerials and the Colorado Mined <br />Land Reclamation Act for Hard Rock, Metal, and Designatecl1fining Operations. An)- alteration or modification to <br />this form shall result in voiding this form. <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />+t` <br />Applicant: ( ,]pl� IGR�?•�_J �1i Representative Name. r <br />K ry1 L V. Q. <br />(Please print) (Please print) <br />Date: OC-Tvbet- q <br />STATE OF COLORADO ) <br />) ss. <br />COUNTY OF El PASO ) <br />Title: p <br />The foregoing was acknowledged before me this 00A duty of DM�, 2018, by <br />I -t. �i-4 <br />` as�JA� Wy'1fi- o f 4710 kj aufid1j'i <br />(si tore of n+rner or representative) (title) (company name) t <br />My Commission Expires: 3a I <br />Notary Public Signature <br />ERIC S HOWARD <br />Notary Public <br />State of Colorado <br />Notary ID 0 20144021884 <br />MX Commission Expires 05-30-2022 <br />Page 2 of 3 <br />