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CERTIFICATION GG-N <br /> The Applicant CJK Milting 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 /> damage from the proposed mining operation to the above listed structures located on or within 200 feet of <br /> the proposed affected area described within Exhibit A of the Reclamation Permit Application for Leadrille <br /> 'Mill, He Number M 1990-057. <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 E_rtraction of Construction <br /> Materials and the Colorado alined Land Reclamation Act for Hard Rock,Metal, and Designated <br /> Mining Operations. Any alteration or modification to this forin shall result in voiding this fornt. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant -5lh (n I I nca n.4 L'-C Representative Name -S�e ZAICALI 6 (flic bC.e <br /> Date l l lcl-Z& Title I1 i r <br /> STATE OF 06�G L<<EG ) <br /> )ss. <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this 1`l day of ,' r7�rJe 11 ,20 (J ,by <br /> r�G-t4 as /t L of (,1tAIC 1 'f' /II <br /> My Commission Expires: �-- <br /> Notary Public --r i BETTY YEXLEYY <br /> NOTARY PUBLIC f <br /> STATE OF COLORADO <br /> MIOTARY IC 19944010215 <br /> MY COMMISSION EXPIRES 06/29/2022 <br /> My Commission Expires: <br /> Notary Public <br />