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CERTIFICATION <br /> The Applicant, Arnolds Custom Seeding LLC (print applicant/company name), <br /> by Tyrun HLIWa (print representative's name),as Director (print <br /> representative's title),does hereby certify that Tumpike,LLC (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 Ad 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 /> 1 ` )ss. <br /> COUNTY OF �JA <br /> The foregoing was acknowledged before me this(�I day of I%Y , , 7`e <br /> T NVI Aa w!L as �tv�tC {�?,/ of V`ffy`L1k6- WAnn <br /> C "— My Commission Expires: <br /> tary Public <br /> Ah',SIE C PEAKE <br /> Pub'.ic <br /> .�;e •�olcado <br /> 440'6730 <br /> I Fate%crcm�ssµ<�i=*P.���e904-18-2G22 <br />