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CERTIFICATION <br /> The Applicant, Colorado Milling Company, LLC (print applicant/company name), <br /> by Mark A. Steen (print representative's name), as Agent (print <br /> representative's title), does hereby certify that Xcel Energy (structure owner) shall <br /> be compensated for any damage from the proposed mining operation to the above listed structure(s) <br /> located on or within 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br /> Permit Application for Gold Hill Mill (operation name), <br /> File Number M-1994_117 <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br /> authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock,Metal, and Designated Mining Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant �M '-� � LE-c- Representative Name M-QAk- <br /> Date Ira, Title <br /> STATE OF (36ko .( ) <br /> ss. <br /> COUNTY OFl06. ) <br /> The foregoing was acknowledged before me this 09-day of 7SCkjjL4..e , 2011 , by <br /> 1Aavk. A 84a.- as Axv,aw�(• of <br /> _ My Commission Expires: l 2_,at 12a °1 <br /> Notary Public <br /> CEMRAN LAMICHHANE <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARYmMG6K)IO PrRESJol 94/3 <br /> tlL'COM�M�S610N EXPIflES,TUNE 20.201O <br /> V171 <br /> �� <br /> e <br />