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CERTIFICATION <br /> The Applicant, Amolds 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 Overhead Pwm thw.Mu+gms Quity REA (slruLtuie owner)shell <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 /> rile 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 Rack,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 Amolds Custom Seeding LLC Representative Name Tyrun Huwa <br /> Date March 27t,�2019 Title Director <br /> SPATE OF�t kO ' ) ) <br /> )ss. <br /> COUNTY OF QJ ) <br /> The foregoing was acknowledged before me is,�aday of 1`(_CVI N_k (G by <br /> L\ AA t.+.Qt as_Dive of Clu <br /> My Commission Expires: <br /> otary Public <br /> J'�bEcKE <br /> Notary state of Cotorado <br /> Notary ID#20144016730 <br /> M C mmiapon Ex usa o4.i8-2022 <br />