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CERTIFICATION <br /> The Applicant, Connell Resources, Inc. (print applicant/company name), <br /> by John M. Warren (print representative's name), as Vice President of Operations(print <br /> representative's title), does hereby certify that Mellott, Richard and Charleen K (structure owner) shall <br /> be compensated for any damage from the proposed mining operation to the above listed structure(s) <br /> located on or within 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br /> Permit Application for Lazy Two Pit (operation name), <br /> File Number M-2019-001 <br /> I <br /> This form has been approved by the Colorado Mined Land Reclamation 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 /> ACKNOWLEGED BY: <br /> Applicant Connell Resources, Inc. _ Representative Signature <br /> Date Title Vice President or-Operations — <br /> STATE OF <br /> ) ss. <br /> COUNTY OF ��++ <br /> The foregoing was acknowledged before me this Aiay of t-�t_9�'� , 20j,by <br /> _(Y1 k�Mj\as Ice Prt d of C6%ne a ReswLc �``G. <br /> bQtcA_ My Commission Expires: <br /> Notary Public <br /> JENNIFER LINDBLAD <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY tD 20144008302 <br /> MY COMMISSION EXPIRES FEB.21.2022 <br />