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lr } <br /> CERTIFICATION <br /> The applicant, Oldcastle SW Group, Inc. , represented by Rich Umbel <br /> as, President does herby certify that Huerfano County(structure owner) shall be <br /> 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 the Reclamation <br /> Permit for Franciscotti Pit, File Number M-2018-058. <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 /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: (Signature of Officer) <br /> Applicant Oldcastle SW Group, Inc. Representative Name: Rich Umbel <br /> Date: C— I — oak Title: President <br /> STATE OF ) <br /> )ss. <br /> COUNTY OF 'T o I� ) <br /> The foregoing was acknowledged b re me this �'� day of , 20 21, by <br /> �C ` tw Ll as Y,.PSi�c�1n of( `\AWLI uo 0--motk(D <br /> ►"1•`` s HEIDI R. VEACH My Commission Expire Z =Commission Number 701199 <br /> Notary Public ow► My Commission Expires <br /> January 14, 2024 <br />