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'U1 <br /> CERTIFICATION <br /> The Applicant,Turkey Canon Quarry Inc.,by M as ic, y�� as V,c /aZ s,� —;:-does hereby certify <br /> that WOODMEN HEIGHTS METRO DIST NO 1 (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 form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant: 'Tv=q.G t (;�ni00 QUi1t¢Q_� ; 1(,, Representative Name: iY� �, V j. <br /> (Please print) (Please print) <br /> Date: OCA—Vbe - q Title: y((.j J"010 <br /> STATE OF COLORADO ) <br /> ss. <br /> COUNTY OF El PASO ) <br /> The foregoing was acknowledged before me this 00A day of wlV6 , 2018, by <br /> 4k—A' Mm-E.� as I�L(i �VWYAX of � G WOO dt,t,wcwU-� t ING <br /> (si ture of owner or representative) (title) (company name) <br /> My Commission Expires: NIA A3D ?V2� <br /> Notary Public Signature <br /> ERIC S HOWARD <br /> Notary Public <br /> State of Colorado <br /> Notary ID It 20144021884 <br /> My Commission Expires 05-30-2022 <br /> Page 2 of 3 <br />