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CERTIFICATION <br /> The Applicant, Martinez Western Constructors Inc. <br /> By Paul Martinez <br /> As Vice President, does hereby certify that River Place LLC, (structure owner) shall <br /> be compensated for any damage from the proposed mining operation to the above listed <br /> structure(s) located on or within 200 feet of the proposed affected area described within Exhibit <br /> A, of the Reclamation <br /> Permit Application for Ducray Pit (operation name), <br /> File Number M-2018-018. <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 <br /> Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock, Metal, and Designated Mining <br /> Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWL <br /> Applicant Representative Name <br /> <— <br /> Date Title <br /> STATE OF ) <br /> ss. <br /> COUNTY OF ,��,)) <br /> The foregoing was acknowledged before me this #Lday of , , 20 , by <br /> � f <br /> i (✓;X74 F t, as U�L�e F,g >D ofrn, r ). e. <br /> / My Commission Expires: c,3 !d 'Z,n"Zf, <br /> Notary Public <br /> ANNE DUSTIN <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID#20044009724 <br /> My Commission Expires March 18,2020 <br />