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S16 <br />CERTIFICATION <br />The Applicant, Turkey Calton Quarry inc., by&Ae zjy, ,�„ `, �; as V, _, p,,i'sI.�� .;does hereby certify <br />that _NICHOLAS A OR EBONY L CAUGHRON (s(ructure owners) shall be compensated <br />for any damage from the proposed mining operation to the above listed structure(s) located within 200 feet of the <br />proposed affected area described within Exhibit A, oflhe Reclamation Permit for Vollmer Pit, <br />File Number M-1983-035. <br />Signature ofApplic <br />This fo►ni has been approved by the Colorado Milled Lund Reclamation Board pansuant to its anlhority <br />under the Coloiado hand Reclamation Act for the Extraction of Construction Materials and the Colorado Mined <br />Land Reclmnation Act for Hard Rock, Metal, and Designated Mining Operations. Ani, allegation or modification to <br />this form shall result in voiding this font. <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />0J � <br />Applicant: JAW1 �W �i�,.t SVC Representative Name: K tial L M. <br />(Please print) (Please print) <br />Date: DC- -Vbel- <br />STATE OF COLORADO j <br />ss. <br />COUNTY OF EI PASO ) <br />Title: �4_L&000- <br />The foregoing was acknowledged before me tris q_%day of DMb , 2018, by <br />as QVJ �P W6-'k1C - of (,040 � I IN(,. <br />(si ture of oumer or representative) (title) (company name) <br />5 <br />My Conunission Expires: 3a 1 '2<)2Z— <br />Notary Public Signature <br />ERIC S HOWARD <br />Notary Public <br />State of Colorado <br />Notary ID A 20144021884 <br />My Commission Expires 05-30-2022 <br />Page 2 of 3 <br />