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CERTIFICATION <br /> The Applicant, JH Sand&Gravel, LLC (print applicant/company name), <br /> by Jim McCuistion (print representative's name),as President _ (print <br /> representative's title),does hereby certify that Southeast Colorado Power Assoc. (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 JH Sand&Gravel,LLC (operation name), <br /> File Number M-ent s79-131 . <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant io 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 /> ApplicantifL a.y_ 4 ytI,LLC -Representative Name GemAthityy <br /> Date 1- 1 (C( Title rest(lert, <br /> STATE OFAor011 t.) ) KARA HINKHOUSE <br /> )SS NOTARY PUBLIC-STATE OF COLORADO <br /> COUNTY OF CI o ) NOTARY ID 20184047966 <br /> MY COMMISSION EXPIRES DEC 18,2022 <br /> The foregoing was acknowledged before me this IS day of_;t1r,;uu.r 20 lq,by <br /> McClulc{iOn as Pe iVA, of }{ S� 9 r&V ELC <br /> likk vtc+k-i.. My Commission Expires.-.__ ..c.• tV,:410 _ <br /> Notary Public <br />