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CERTIFICATION <br /> The Applicant, Martinez Western Constructors Inc. <br /> By Paul Martinez <br /> As Vice President, does hereby certify that Brian C Bennett, (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 /> ACKNOW <br /> plicant Representative Name <br /> Date /mil Title <br /> STATE OF <br /> ) ss. <br /> COUNTY OF <br /> The foregoing was acknowledged before me this?-A day of Vfvv 20a, byrr. <br /> U as y{,E-r 4 4y of re( r D"' <br /> My Commission Expires: cu 2n`1iz,. <br /> Notary Pub is <br /> ANNE DUSTIN <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID#20044009724 <br /> My Commission Expires March 18,2020 <br />