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CERTIFICATION <br /> The Applicant, Aggregate Industries - WCR, Inc. (print applicant/company name), <br /> by W. Chance Allen (print representative's name), as Region Head (print <br /> representative's title),does hereby certify that The City of Aurora (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 Wattenberg Disturbance Resl tee jYIY�(�. �� ; (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 -, _ : Representative Name <br /> Date Title <br /> STATE <br /> )ss. <br /> COUNTY OF ) <br /> -v <br /> The foregoing was acknowledged/,before me this day of F�-t,C >� , 20�,by <br /> as�[��,!_ <br /> >)tc Lc My Commission Expires: <br /> Notary Public <br /> KAREN ROMERO <br /> NOTARti PUB[ IC <br /> STATE OF COLORADO <br /> IJnT'�RY ID 201 i40168�,6 <br /> r,1"•ISM'!%EXPIRES APRIL 16 ZU« <br />