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CERTIFICATION <br /> The Applicant, Carol Ann Pit, LLC, by Robert W. Newby& Carol Ann Newby, does hereby <br /> certify that_Black Hills Energy (structure owner) shall be compensated for any damage <br /> from the proposed mining operation to the above listed structure(s) located on or within 200 <br /> feet of the proposed affected area described within Exhibit A, of the Reclamation Permit <br /> Application for Carol Ann Pit, File Number M-1997-026. <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority under <br /> the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land <br /> 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 Carol Ann Pit, LLC Representative Name u <br /> Date t-o— azu k�. Title OAp ,,,'l6'0 r <br /> STATE OF ) <br /> ss. <br /> COUNTY OF C[. ) <br /> The foregoing was acknowledged before me thisir day of ,20 1 by <br /> f°f:)nX4-W Ov& 1 <br /> My Commission Expires:_��1/ 9 <br /> 6Nota�Public <br /> ®ANETTE M SCHLEGEL <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 2003+006913 <br /> �Y Commission Expires February 27,2019 <br />