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CERTIFICATION <br /> The Applicant, J-2 Contracting Company (print applicant/company name), <br /> by Chris Leone (print representative's name), as President (print <br /> representative's title), does hereby certify that Weld County (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 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-Z7 Title President <br /> STATE OF ) <br /> )ss. <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this day of 20Q2,by <br /> Chris Leone as President qff J-2 Contracting Company <br /> �- My Commission Expires: <br /> WYKRWO-C L SHIMA <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20084008717 <br /> COMMISSION EXPIRES MARCH 12,2029 ryoam; <br /> 9 <br />