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CERTIFICATION <br /> The Applicant, Southway Construction Company, Inc.of Alamosa, by Alonzo Salazar,as Office <br /> Manager,does hereby certify that David and Cindy Driscoll(structure owner)shall be <br /> 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 the Bradford Mesa Quarry, File Number M-2019-046. <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority under the <br /> 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 this <br /> form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> S0# rr+ CANS "CTi AI cbwe.P1+JVy ►,:'NR.. t9 A-ur o d A <br /> Applicant 0( �—Representative Name /�L 4,u Lo S`A-ort-z tic,_ <br /> Date /P h// Title D FFICC- Aot A-,V* <br /> STATE OF 60"A"O } <br /> )ss. <br /> COUNTY OF Atk^WSA ) <br /> The foregoing was acknowledged before me this i?tAday of CaGTV tire& •20.Li by <br /> &?pj2v SA4A"ZAvL. as OFP+CC /ktfint'Il"X_ of Sbag%vj�ff Co riod 004-0*0y..Z*rc <br /> My Commission Expires: <br /> N-6tary Public <br /> TRACIE L MECRNA <br /> PuBLIC <br /> STATETARY OF COLOR DO <br /> NOTARY tD 19974017634 <br /> My CoimtNWW F.xorra 10-M-2021 <br />