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CERTIFICATION <br /> The Applicant, Arnolds Custom Seeding LLC (print applicant/company name), <br /> by Tyrun Huwa (print representative's name),as Director (print <br /> representative's title),does hereby certify that Sarah Petty (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.i (operation name), <br /> File Number M- 1Ulb 012 . <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 C-) :`kc ) ) _ ) <br /> _{ )ss. (/ <br /> COUNTY OF Wt- <br /> The foregoing was acknowledged before me this a day of I%VCVA, Y c <br /> �( as C-K�y/ of L I <br /> C My Commission Expires: \' -' U <br /> tary Public <br /> E C P E A K E <br /> r , ,4221/4016730 <br /> 1..�':�L�:•.`.r.._ � _r,>p.roau4.18-2022 <br />