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CERTIFICATION <br /> The Applicant, Castle Rock Construction Company of Colorado, LLC (print applicant/company name), <br /> by (print representative's name), as (print <br /> representative's title), does hereby certify that Duane and Brenda Stoker (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 STOKER BORROW PIT (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: 600k� <br /> Castle Rock Construction Company of Colorado,LLC z <br /> Applicant Representative Name � <br /> Date -47A 2oZZ Title <br /> STATE OF CotoraJ-0 ) <br /> ) ss. <br /> COUNTY OF A-rl p,h JL ) <br /> The foregoing was acknowledged before methis?`t,.`day of Fe�t"il,o(I_, 20)Z, by <br /> A 1ti j \,r' 1.7.'��L 1 as C V y of Castle Rock Construction Company of Colorado,LLC <br /> My Commission Expires: Z 1 i 01 <br /> Notary Public <br /> ;AViD BROOKS <br /> Notary Public <br /> State of Colorado <br /> Nota-, ) # 201 54047623 <br /> My Comm., I <br /> pires 12-11-202.3 <br />