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S48 <br /> CERTIFICATION <br /> The Applicant,Turkey Cation Quarry Inc,,by M,a'z k M v r;- as y,6� P,",✓c ,-does hereby certify <br /> that JAMES T OR JANICE M SCHLIEPER (structure owners)shall be compensated <br /> for any damage from the proposed reining 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 fornt has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority <br /> cinder 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 form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant: fi t '�a0 ath Representative Name: wu t1n 0 L�"y <br /> (Please print) (Please print) <br /> Date: Y7bL - Title: Vt l4 f 2,1&O(W <br /> STATE OF COLORADO ) <br /> ss. <br /> COUNTY OF El PASO ) <br /> The foregoing was acknowledged before me this day of wh , 2018, by <br /> (si ture of owner or representative) (title) (company name) <br /> My Commission Expires: NIAA3D ?l <br /> Notary Public Signature <br /> ERIC S HOWARD <br /> Notary Public <br /> State of Colorado <br /> Notary 1D N 20144021884 <br /> My Commission Expires 05-30-2022 <br /> Page 2 of 3 <br />