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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 Boulder county Transportation Department(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 /> crxa� � MsVk mn <br /> Applicant LL—C . Representative Name MAR ik- A - S+QJQ� <br /> Date -PI 19 Title <br /> STATE OF COkCIM ) <br /> COUNTY OF L2j p1A ) ss. <br /> The foregoing was acknowledged before me this 62day of 54.%q , 20 LOt, by <br /> i-ka)(L A as A-,Pj e,A,� of CO�QN I <br /> My Commission Expires: r[ 124 <br /> Notary Public <br /> JAN 0 2 2W2014 ffW <br /> Boulder Cou, ,y <br /> Transportation <br />