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CERTIFICATION <br /> The Applicant, 2"D GENERATION MINING, LLC (print applicant/company name), by JIM REED (print <br /> representative's name, as OPERATOR (print representative's title), does hereby certify that USDA FOREST <br /> SERVICE (structure owner) shall be compensated for any damage from the proposed mining operation to <br /> the above listed structure(s) located on or within 200 feet of the proposed affected area described within <br /> Exhibit A, of the Reclamation Permit Application for JJ COLLECTING PROJECT#1 (operation name), File <br /> Number M-2018-064. <br /> This form has been approved by the Colorado Mined lams'Reclannation Board pursuant to its <br /> authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock, Metal, and Designated Mining Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLE BY: <br /> Applicant Representative name rh►-vtc°S <br /> Date -1, 6 Z Title �PC&5(f +t <br /> STATE O F IV, n n <br /> COUNTY OF Cr-6r),,-j IJ;r ) <br /> S� <br /> The foregoing was acknowledged before me this-2 � "-day of (�'1 c�� c , 20 2 / , by <br /> �QUY e t4 - /&--"` as r�5 L�.1 <.�i v y cf <br /> ��I)W - &A-6J 6-10 My Commission expires: - 3 <br /> Notary Public <br /> ELLEN M MATHISON <br /> NOTARY PUBLIC-MINNESOTA <br /> MY COMMISSION EXPIRES 01/31/2021 <br /> RECEIVED <br /> MAR 2 5 2019 <br /> South Park <br /> Ranger District <br />