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S36 <br /> CERTIFICATION <br /> The Applicant, Turkey Caiion Quarry Inc.,byM A-71:, n., ,_r,rs e- as „_� p�s�✓- does hereby certify <br /> that ERIC D OR MIALESHONDYA TUCKER (structure owners)shall be compensated <br /> for any damage from the proposed mining operation to the above listed struclure(s)located within 200 feet of the <br /> proposed affected area described within Exhibit A,of the Reclamation Pcrntit for Vollmer Pit, <br /> File Number M-1983-035. <br /> Signature of Applica <br /> This form has been approved by the Colorado Mined Land Reclamation Board prnsuant to its authority <br /> under the Colorado Land Reclamation Act for the Extraction of Connstrztctiener Materials and the Colorado Minted <br /> Land Reclamationt Act far•Heird Rock, Metal, and Designated Mining Operations.Ann alteration or modification to <br /> this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> N � <br /> Applicant: �Ul t. ')s61� ( ld1t¢Q- t(,� Representative Name: I' aL� "yI V.I. <br /> (Please print) (Please print) <br /> Date: _OC• 'Oe-L U jb Title: V J(J J U&WS <br /> STATE OF COLORADO ) <br /> )ss. <br /> COUNTY OF El PASO ) <br /> The foregoing was acknowledged before me this 9�— day of Dyf� , 2018, by <br /> 1�41A�41 ���.#%"1 as �l(� '�l tit of `�� GO'no �— G . <br /> (si re of owner or representative) (title) (company name) <br /> My Commission Expires: dDZ-- <br /> Notary Public Signature <br /> ` ERIC S HOWARD <br /> Notary Public <br /> State of Colorado <br /> Notary 10 N 20144021894 <br /> M Commission Expires 05-30-2022 <br /> Page 2 of 3 <br />