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S19 <br />CERTIFICATION <br />The Applicant, Turkey Canon Quarry Inc., byM A*2V as V, 6g P Ivs,v�= -; docs hereby certify <br />that JERRY OR NANCY NELSON {structure owners) shall be compensated <br />for any damage froth the proposed mining operation to the above listed structure(s) located within 200 feet ofthe <br />proposed affected area described within Exhibit A, of the Reclamation Pcrmit for Vollmer Pit, <br />File Number M-1983.035. <br />Signature ofApplican <br />This forut has been approved by the Colorado Milled Land Reclamation Boats prnsuant to its authority <br />under the Colorado Land Reclanurtion Act for the Extraction of Constrirctiot Materials and the Colorado Milled <br />Land Reclamation Act few Hard Rock, Metal, and Designated Mining Operations. Any alleratior or• modification to <br />this form shall result in voiding this form. <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant: � �lfr4i(� Representative Name: lin L V. P. <br />(Please print) (Please print) <br />Date: <br />STATE OF COLORADO ) <br />ss. <br />COUNTY OF El PASO ) <br />Title:M c .. "W <br />The foregoing was acknowledged before rite this q—mday of vlv� 2018, by <br />as QV.6 �"cVQUC of 'Q'I�l!'r`>' GAV"00 NkMl-� <br />(si ture of owner or represen alive) (title) (company name) <br />5 <br />My Commission Expires: MIAA3D INotary Public Public Signature <br />ERIC S HOWARD <br />Notary Public <br />Slate of colomdo <br />Nolary ID s 20144021884 <br />My Commission Ex gyres 05.30.2022 <br />Page 2 of 3 <br />