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CERTIFICATION <br /> The Applicant, Washington County - Dist 2 (print applicant/company name), <br /> by Robert Frick (print representative's name), as DRMS Admin. (print <br /> representative's title), does hereby certify that Highline Electric (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 Reclamation <br /> Permit Application for Chris Aageson Pit#2 Addition (operation name), <br /> File Number M- - <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 /> ACKNOWLEGED BY: <br /> Applicant ��a� o�, C vun�/- p�S�•� Representative Name <br /> Date _�tiP f 3, y-0 Title O R MS O o,f" <br /> STATE OF p ) <br /> ss. <br /> COUNTY OF <br /> rb <br /> je.fo�eo �was�acknowledged before me this — day of , 20� by <br /> _�ot. as of <br /> -C My Commission Expires: zo <br /> Notary P lic <br /> 4^#a 1'.Mmfaa <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 19964012722 <br /> My Commission Expires August 10,2020 <br />