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CERTIFICATION <br /> The Applicant, Solberg Gravel LLC (print applicant/company name), <br /> by Robert Solberg (print representative's name), as Managing Partner (print <br /> representative's title), does hereby certify that t?� Energy Partners (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 Solberg Pit 'operation name), <br /> File Number M-1981-044 . <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 Cnlaradn Mined and Reelama- on Act for Hard Roek,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 /> 8 J9 <br /> AC VN0Wl FQF <br /> Applicant Representative Name—, / ' C,'� <br /> Date -, 4 Title Al ef,i a ,// <br /> STATE OF Cab ) <br /> ) ss. <br /> COUNTY OF POS ) ) <br /> Th foregoing was acknowledged before me this t9 day of , <br /> toi_ as of <br /> ' M Commission Expires. <br /> Y � <br /> Notary Public <br /> E <br /> ESSI TUBBS <br /> TARY PUBLIC <br /> OF COLORADO <br /> /D 20174023109 <br /> on Expires 06-01-2025 <br />