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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 Bureau of Land Management(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: A-SOW-Thw" C0NM%4C7)4a#j C-0^4+. <br /> Applicant Al- . . Z. 4P- Representative Name AmLo-j t-0 S'A- � <br /> Date /V Af/j,Y —T"itle 04-ce gt't 5-'!� <br /> STATE OF C010ra-A0 <br /> )ss. <br /> COUNTY OF W-40toM <br /> The foregoing was acknowledged before me this day of 92C401ter 20 by <br /> 414"o 5At,*z,*vL as ce Atm&y of Sow"!!= Co*vrna-c?vwj Comm-iOA"p , N c- <br /> My Commission Expires: <br /> Notary Public <br /> TRAGE L MEOR" <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY 10 199740-17634 <br /> My Comrnission EXPIM IM-2021 <br />