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CERTIFICATION <br /> The Applicant, Oldcastle SW Group, Inc. dba United Companies,by Pete Siegmund, as <br /> Assistant Secretary, does hereby certify that_Scott & Shelia Brennise (4B Land& Livestock <br /> LLC)_(structure owner) shall be compensated for any damage from the proposed mining <br /> operation to the above listed structure(s) located on or within 200 feet of the proposed affected <br /> area described within Exhibit A, of the Reclamation Permit Application for Breeze Basin <br /> Sand&Gravel, File Number M2008-022 <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority under <br /> the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land <br /> Reclamation Act for Hard Rock, Metal, and Designated Mining Operations. Any alteration or modification to <br /> this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant_olacaslle sw Group inc aba United Companles_Itepresentative Name_Peter Sie and <br /> Date _Title Assistant Secretary _ <br /> STATE OF—Colorado ) SONA L.VAN HORN <br /> PUBLIC <br /> )SS. STA ETARY OF COLORADO <br /> COUNTY OF Mesa ) NOTARY 10#20144015627 <br /> My Cor misum Expires April 10,2022 <br /> The foregoing was acknowledged before me thisA ay of r j t1AQ- , 20 L, by <br /> ec�Y� as , , of 6[/Gjah�L & &04410, e . <br /> My Commission Expires: <br /> Notary Public <br />