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CERTIFICATION <br /> The Applicant, Asphalt Specialties Co., Inc. by Daniel W. Hunt, as President, does hereby certify <br /> that the Phyllis Burk rg_en (structure owner) shall be compensated for any damage from the <br /> proposed mining operation to the above listed structure(s) located on or within 200 feet of the <br /> proposed affected area described within Exhibit A, of the Reclamation Permit Application for <br /> File number M 2021-067, the Stiles Mining Resource. <br /> This form has been approved by the Colorado Mined Land Reclamation Board <br /> pursuant to its authority under the Colorado Land Reclamation Act for the Extraction of <br /> Construction Materials and the Colorado Mined Land Reclamation Act for Hard Rock,Metal, <br /> and Designated Mining Operations.Any alteration or modification to this form shall result in <br /> voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Applicant: Asphalt Specialties Co., Inc. Representative Name: Daniel W. Hunt <br /> Date: Title: President <br /> STATE OF Colorado ) <br /> ss. <br /> COUNTY OF Adams ) <br /> The foregoing was acknowledged before me this day of /Vole be>2, 20j±, by <br /> Daniel W. Hunt as President of Asphalt Specialties Co. Inc. <br /> My Commission Expires: 29 <br /> Not Public <br /> JAN NELSON <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 199"030527 <br /> My Commission Expires April 29,2024 <br /> H:\Pits HBP Plants\EVANS\Evans Mining Resource\Exh S-Permanent Manmade Structures\L.etter Structure Agreement Burkgren.doc <br />