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CERTIFICATION <br /> The applicant, Oldcastle SW Group. Inc. , represented by Rich Umbel <br /> as, President ,does herby certify that does herby certify that San Isabel Electric <br /> Association, Inc. (structure owner) shall be compensated for any damage from the proposed <br /> mining operation to the above listed structure(s) located on or within 200 feet of the proposed <br /> affected area described within the Reclamation Permit for Velarde Pit, File Number M-2002- <br /> 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 Oldcastle SW Group, Inc. Representative Name: Rich Umbel <br /> Date: - 1 7 -,e� Title: President <br /> STATE OF -� ) <br /> COUNTY OF )ss.l �a _) <br /> The foregoing was acknowledged before me this day ofl.�L 20,)-1 by <br /> t4L as _ ,('d 'c �-4 o ))d CCrs-FL SW 0-,,q_ <br /> My Commission Expires: o l+ HEIDI R. VEACH <br /> Notary Public : mission"�um-6er 701199 <br /> My Commission Expires <br /> AV January 14, 2024 <br />