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CERTIFICATION <br /> The Applicant CJK Milling Company,LLC,By Stephanie Michael,as Manager,Union Milling <br /> Contractors,LLC,does hereby certify that Leadville Sanitation District shall be compensated for any <br /> I <br /> damage from the proposed mining operation to the above listed structures located on or within 200 feet of <br /> i <br /> the proposed affected area described within Exhibit A of the Reclamation Pemut Application for Leadville <br /> Mill,File Number M2021-058. <br /> I <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant <br /> to its authority under the Colorado Land Reclamation Act for the Extraction of Construction <br /> Materials and the Colorado Mined Land Reclamation Act for Hard Rock,Metal, and Designated <br /> Mining Operations.Any alteration or modification tothis form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant C--TK 01.11inqG r n Representative Name <br /> Date "[J�i, 11,l Title 0,em UPr <br /> STATE OF V6Jwa4, ) <br /> )ss. <br /> COUNTY OF&an u d ) <br /> The foregoing was acknowledged before me this day of „�Q jaoj o Pj ) ,20�,by <br /> j <br /> han.t.g�? a,o_ as n1em_ber of GJk n g- <br /> I <br /> I <br /> My Commission Expires:_17-) tUAAU <br /> Notary Pu is <br /> i <br /> i <br /> My Commission Expires: I <br /> Notary Public <br /> 1, <br /> i <br /> CARA J. EVENSON <br /> MW tJotary Public-State of Kansas ' <br /> MyAppt.Expires January 25,2026 II <br /> I <br /> I <br />