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14TRUCKMMG <br /> 24125 CR 42 <br /> AMIDEXCA1.1 0.IN, LaSalle, CO 80645 <br /> CERTIFICATION 970-378-7000 <br /> The Permit Applicant and Mine Operator, Justice Trucking, Inc. by Russ Justice, as _Owner, <br /> (Title) does hereby certify that State Board of Land Commissioners (structure owner) shall be <br /> compensated for any damage from the proposal mining operation to the above listed structure(s) <br /> located on or within 200 feet of the proposed affected area described within the letter attached to <br /> this agreement, as of the Reclamation Permit for GoodMiller#2 Pit, Permit File Number M- <br /> 2014-070. <br /> This form has been approved by the Colorado Mined Land Reclamation 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 of this form shall result <br /> in voiding this form. <br /> NOTARY FOR PERMIT APPLICATION <br /> ACKNOWLEDGED BY: <br /> Applicant Justice Truckin Inc Representative Name Russ Justice <br /> 31 'VA-- <br /> Date Januarv30-, 2020 Title Owner <br /> STATE OF Colorado <br /> ) ss <br /> COUNTY OF Weld) <br /> 2 OZ o`�3t�• <br /> The foregoing was acknowledged before me theSk, day of oan r �' 241-5 <br /> — �by <br /> Russell Justice, as Owner of Justice Trucking, Inc. <br /> My Commission Expires: <br /> Notary Public <br /> DELANIE MCMORRIS <br /> NOTARY PUBLIC <br /> STATE OF COLORAD:29,2]020 <br /> NOTARY ID 201640450 <br /> MY COMM.EXPIRES NOVEMBER 2 <br />