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CERTIFICATION <br /> The Applicant, Arnolds Custom Seeding LLC (print applicant/company name), <br /> by Tyrun Huwd (piinL iepiesentdtive's fame),as Director (print <br /> representative's title),does hereby certify that Elaine and Frederick Hepner (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 <br /> Reclamation Permit Application for Arnold Pit No.1 (operation name), <br /> File Number M 201b 022 . <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 /> ACKNOWLEDGED BY: <br /> Applicant Arnolds Custom Seeding LLC Representative Name Tyrun Huwa <br /> Date Marc((h1l,27,2019 Title Director <br /> STATE OF <br /> COUNTY OF WC�� ))ss. <br /> The foregoin was acknowledged before me this day of, V9 , by i — <br /> V..i(3- as 0VQ. � of Ay� �C CTE T l <br /> My Commission Expires: l L� <br /> N tary Public <br /> JAMSIE C PEAKE <br /> Notary Public <br /> I State of Colorado <br /> Notary In:Y?0144016730 <br /> My"Cmmiss on Ex fires 04.18 2022 <br />