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CERTIFICATION <br /> The Applicant, Arnolds Custom Seeding LLC (print applicant/company name), <br /> by Tyrun Iluwa (print fepresentative's name),as Director (print <br /> representative's title),does hereby certify that Stanley Gingerich (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- 2016 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 March 27,2019 Title Director <br /> STATE OF ) <br /> )ss. <br /> COUNTY OF WA'82 ) <br /> The foregoing was acknowledged before me this(�I day of I%V <br /> n "A Cl_ as C / of ' I A <br /> My Commission Expires: <br /> tary Public <br /> h',SIE7 PEAKE <br /> e c!—ado <br /> t Y ;a22'c4016730 <br /> `:.-,4 Kp resu4-18 2022 <br />