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I <br /> S35 <br /> CERTIFICATION <br /> The Applicant,Turkey Canon Quarry Inc.,by M,a2 V-, ff as does hereby certify <br /> that VANESSA CAROL MALEWITZ (structure owners)shall be compensated <br /> for any damage from the proposed mining operation to the above listed structure(s)located within 200 feet of the <br /> proposed affected area described within Exhibit A,of the Reclamation Permit for Vollmer Pit, <br /> File Number M-1983-035. <br /> Signature ofApplica <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority <br /> under the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined <br /> Land Reclamation Act for Hard Rock, Metal, and Designated Mining Operations.Any alteration or modification to <br /> this form shall result in voiding this fo-m. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant: jJAW (000 �GR>�� ;lft( Representative Name: m �" V,Q. <br /> (Please print) (Please print) <br /> Date: 0('8(7e7t- ` Title: <br /> STATE OF COLORADO ) <br /> ) ss. <br /> COUNTY OF El PASO ) <br /> The foregoing was acknowledged before me this" day of DMW , 2018, by <br /> as_�Ld �MVAX of q��4 G ATJD+J � l ING. <br /> (sipwture of owner or representative) (title) (company name) <br /> My Commission Expires: NIA A3D LV2� <br /> Notary Public Signature <br /> ERIC S HOWARD <br /> Notary Public <br /> State of Colorado <br /> Notary 1D 4 20144021884 <br /> M Commission Expires 05-30-2022 <br /> Page 2 of 3 <br />