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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 (print <br /> representative's title),does hereby certify that Mark Arnusch (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 Colorado ) <br /> )ss. <br /> COUNTY OF Adams ) <br /> Th foregoin was acknowledged before me thisO(Aday of a0/ y <br /> WCZ, as T_&6-f GfU ' of 0 <br /> l My Commission Expires: <br /> Notar ublic MONICA L VICKERS <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20034011009 <br /> MY COMMISSION EXPIRES 6/1012023 <br />