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S44 <br /> CERTIFICATION <br /> The Applicant,Turkey Canon Quarry Inc.,byM A2►, M (_V�- as V+._N hereby certify <br /> that NORMAN C OR THREASE WOOD (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 /> l <br /> This form has been approved by the Colorado Mined Lind Reclamation Board pursuant to its authority <br /> under the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Milted <br /> Land Recianratioii Act for Hard Rock,Metal and Designated Mining Operations.Array alteration or modification to <br /> this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant: 'TAW O't 1010 W1t tQ 10b Representative Name: rA � V. <br /> (Please print) (Please print) <br /> Date: OCR - -L q . Zo 1� Title: V14 ft&00 <br /> STATE OF COLORADO ) <br /> )ss. <br /> COUNTY OF El PASO ) <br /> The foregoing was acknowledged before me this" day of 2018,by <br /> M - e Ntig as W ? cOwV of �'? <br /> (s' ture of owner or representative) (title) (con4my name) <br /> My Commission Expires:M61AA3D � <br /> Notary Public Signature <br /> ERIC S HOWARD <br /> Notary Public <br /> State of Colorado <br /> Notary 10 M 20144021884 <br /> My Commission Ex iris 05-30-2022 <br /> Page 2 of 3 <br />