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r <br /> CERTIFICATION <br /> The applicant, Oldcastle SW Group, Inc. , represented by Rich Umbel <br /> as, President , does herby certify that does herby certify that Frank Velarde (structure <br /> owner) shall be compensated for any damage from the proposed mining operation to the above <br /> listed structure(s) located on or within 200 feet of the proposed affected area described within the <br /> Reclamation Permit for Pino Pit, File Number M-2002-118. <br /> This form has been approved by the Colorado Mined Land Reclamation Board 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 or modification to this <br /> form shall result in voiding this form. <br /> ACKNOWLEDGED BY: (Signature of Officer) <br /> Applicant nOldcastle SW Group, Inc. Representative Name: Rich Umbel <br /> Date: "I — (-7—�a�21 Title: President <br /> STATE OF � ) <br /> �_. )ss. <br /> COUNTY OF +I � ) <br /> The foregoing was acknowledged before me this 1-1 day of , 2(u11, by <br /> w-L as c I V BPS IrAzttt of <br /> s� HEIDI R. VEACH <br /> �\ V My Commission Expires: Z Commission Number 701199 <br /> Notary Public My Commission Expires <br /> ow► January 14, 2024 <br />