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CERTIFICATION <br /> I <br /> The Applicant, J-2 Contracting Company (print applicant/company name), <br /> by Chris Leone (print representative's name), as President (print <br /> Hunt teen d K David an a <br /> representative's title), does hereby certify that y (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 /> i <br /> Permit Application for Hunt Irrigation Pond (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 J-2 Contracting Company Representative Name Chris Leone <br /> Date /(-/0 Title President <br /> STATE OF a z? d ) <br /> ss. <br /> COUNTY OF�GlL <br /> The foregoing was acknowledged before me this day o ��,20 , y <br /> Chris Leone as President J-2 Contracting Company <br /> / My Commission Expires- <br /> CAROL L SHIMA <br /> STATE OF COLOORIACDO <br /> MY COMM OON VIBE 17 <br /> 2,202s <br />