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CERTIFICATION <br /> The Applicant, APC SOUTHERN CONSTRUCTION CO. LLC (print applicant/company name), <br /> byJames MacDonald (print representative's name), as Project Manager (print <br /> representative's title), does hereby certify that San Isabel Electric Assoc. (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 FRANCISCOTTI PIT#2 (operation name), <br /> File Number M- - <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br /> authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock, Metal,and Designated Mining Operations. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant PC , (�,Q,.,I Representative N e <br /> Date 7 � o/ o, Title <br /> STATE OF Ca lri coo(d ) <br /> ) ss. <br /> COUNTY OF A—rlzi2—-- ) <br /> The foregoing was acknowledged before a this-�PLday of krnAa _, 20&,,b / <br /> 'r-L L1At�--LZ--as—LC .s—— r-4 _of — i�L.Iz dZ <br /> r{ JGt My Commission Expires:_ <br /> No aiy Public <br /> SHAUNA L.VUCETICH <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20134069448 <br /> MY Commission Expires 11-01-2021 <br />