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CERTIFICATION <br /> The Applicant, Oldcastle SW Group, Inc. dba B&B Excavating, by Pete Siegmund, as <br /> Assistant Secretary, does hereby certify that �,tt�jh�1�O�Ca` �iC kl �Mo'd (structure <br /> owner) shall be compensated for any damage from the proposed mining operation to the <br /> above listed structure(s) located on or within 200 feet of the proposed affected area described <br /> within Exhibit A, of the Reclamation Permit Application for Carol Ann Pit, File Number M- <br /> 1997-026. <br /> This form has been approved by the Colorado Alined Land Reclamation Board prirsuant to its authority under <br /> the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land <br /> Reclamation Act for Hard Rock, Aletal, and Designated Mining Operations.Any alteration or modification to <br /> this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: ; <br /> ok do 0'5�e� 6-ov p ,7 nc... 1 .. <br /> Applicant b epresentative Name jL <br /> Date <br /> STATE OF �C' c ) <br /> ss. <br /> COUNTY OF <br /> The foregoing was acknowledged before me this day of e PacdPi 20/F, by <br /> r F� J as (/,c IC of <br /> My Commission Expires: <br /> Notary Public <br /> GENEVIEVE N1.BLECHA <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID#19914003259 <br /> My Commission Expires April 4,2o19 <br /> ,V,L�fL� <br /> G'� <br />