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r <br /> CERTIFICATIO\ <br /> The Applicant, 94 ( 15�� �dJ S� ��-Z�C (print applicant company name). <br /> by �'e-" ' C (print representative's name). as ► ► C(ke?fit! _ (print <br /> representative's title),does hereby certify that O."t ) (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 to,._-TU (� 1�1_._�� _-_--(operation name). <br /> File Number M-Zed-eD. <br /> This Joan has been approved bt•the Colorado Alined Land Rec•larnation Board pursuant to its <br /> authority-under the Colorado Land Reclamation Act for the F_rtraction of Construction.Materials and <br /> the Coh;rado .►lined Land Reclamation Ac•t for Hard Rock, Metal. and Designated.fining Operations <br /> tnr alteration or modification a►this form shall result in roiding thi.e firm. <br /> I <br /> j NOTARI- FOR PERMIT APPLICANT <br /> ACKNOW-EGED BY: <br /> Applicant S4 /` �� COt/k J5/V�-c L�representative Namejd _ L.I r 4T <br /> Date .._../-7 S/?O`Z I Title MO ut e- <br /> STATE OF CO ) <br /> )ss. <br /> COUNTY OF Est %0 ) <br /> The c re oing as acknowledged before nw this 45 day of 1 to )o 2(, b <br /> as—►"l4aI'-- of ►ill' �C. <br /> v a� __ My Commission Expires: 4 /Z �_ _ <br /> Pdlic <br /> .ZssE CNARLM STMAILE <br /> NOTARY PUBIC <br /> STATE Of COIORADO <br /> NOTARY ID 20196014000 <br /> Iw COMM S&C M EXPWaS APRR 12.2022 <br />