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CERTIFICATION <br /> The Applicant,Asphalt Specialties Co.,Inc.by Daniel W.Hun#, as President,sloes hereby certify <br /> that the Xcei Ener»v(structure owner) shall be compensated for any damage from the proposed <br /> mining operation to the above listed structures)located on or within 200 feet of the proposed <br /> affected area described within Exhibit A,of the Reclamation Permit Application for File number <br /> M 2021-067,the Stiles Mining Resource. <br /> This form has been approvers by the Colorado Mined Land Reclamation Board <br /> pursuant to its authority under the Colorado Land Reclamation A ctfor the Extraction of <br /> Construction Materials and the Colorado Muted Land Reclamation Act for Hard Rock,Metal, <br /> and Designated Mining Operation&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: I/,-/Z� Title: President <br /> STATE OF Colo do ) <br /> ) ss. <br /> COUNTY OF Adams ) �� <br /> The foregoing was acknowledged before me this �4 day of Na ye,,6,, ,20ft-f;by <br /> Daniel W.Hunt as president of Asphalt Specialties Co. Inc. <br /> No ; :gpjjMy Commission Expires: o� <br /> ubli( <br /> JAN NELSON <br /> NOTARY PUBLIC <br /> STATE OF COLO,OADO <br /> NOTARY ID 19994030627 <br /> My Co Tonission Expires April 29,2024 <br /> HAPits HBP Plants\EVANS\Stiles Mining Resource\Exh S-Permanent Manmade Structures\Utter Stricture Agreement Xcel UTILUY.doc <br />