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CERTIFICATION <br /> The Applicant, Martinez Western Constructors inc. (print applicant/company name), <br /> by Paul Martinez (print representative's name), as Vice President (print <br /> representative's title), does hereby certify that City Of Grand Junction (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 Ducray Pit 2 (operation name), <br /> File Number M-2019-035 . <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursttant to its <br /> authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br /> the Colorado Mined Lund Reclamation Aet,for Hard Rock, Metal, and Designated Minim; Operations. <br /> Any alteration or modification to this form shall result in voidinb this fornt. <br /> NOTARY FOR PERMIT APPLICANT <br /> R <br /> � T � <br /> ACKNOWLEGED BY: <br /> r <br /> Applicant_1. � �. ,".yi • �I." ( �`.r `;try € 'L ( �. Representative Name <br /> Date 1" 1 Title <br /> STATE OF <br /> ss. <br /> COUNTY OF <br /> The foregoing was acknowledged before me this ire= day of , 20L�-, by <br /> as Of <br /> My Commission Expires: ' <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 />