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CERTIFICATION <br /> The Applicant, Arnolds Custom Seeding LLC (print applicant/company name), <br /> by Tvrun Huwa (print representative's name),as Director (print <br /> representative's title),does hereby certify that USA (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 August 20,2019 Title Director <br /> STATE OF (40 ) <br /> COUNTY OF 'U�I ))ss. <br /> T e forego was acknowledged before me thi%90 day o 1.�vt ,Ud/l by <br /> as of-C�rLldS ouCfOrYI seedrgq LLG <br /> My Commission Expires: <br /> Notary Public MONICA EWKERS <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20034011009 <br /> MY COMMISSION EXPIRES 61101PQ23 <br />