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CERTIFICATION <br /> The Applicant, Ready Mixed Concrete Company (print applicant/company name), <br /> by Ernest W. Timmons III (print representative's name),as General Manager (print <br /> representative's title),does hereby certify that the City Of Brighton (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 Bromley Lakes, Cell No.1 (operation name), <br /> File Number M- 2015 041 <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/6�-� /,1eC/� ,0/1/ —' e( representative Name Z <br /> Date �� ��f�5� Title 2./— <br /> STATE OF Lolo(A l l ) <br /> ss. <br /> COUNTY OF <br /> The foregoing was acknowledged before me this day of 00c, ,20B ,by <br /> rj V as MAIL4gr of /lr< CencrE n <br /> My Commission Expiresjd Iq <br /> Notary RWIic <br /> MICHAEL FUQUA <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20154022007 <br /> MY 00MMISS1©N EXPIRES JUNE 03,2019 <br />