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CERTIFICATION <br /> The Applicant. Scott Contracting,Inc. (print applicant/company name), <br /> by Tom Roberts (print representative's name),as Vice President of Operations (print <br /> representative's title), does hereby certify that Colorado Department of Transportation (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 Rifle Gravel Pit#1 (operation name). <br /> File Number M- 2020-008 . <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 /> is <br /> Applicant Scott Contracting,Inc. Representative Name Tony Roberts <br /> Date 11/23/2020 Title Vice President of Operations <br /> STATE OF Colorado ) <br /> ss. <br /> COUNTY OF Arapahoe ) <br /> The foregoing was acknowledged before me this�Q_day of November . 20 20 , by <br /> Tony Roberts as VP of Operations of Scott Contracting Inc. <br /> My Commission Expires:&::eLs �_�,ns I— Is-, a <br /> Notary Public <br /> MITZI REECE <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20184011940 <br /> MY COMMISSION EXPIRES MARCH 15,2022 <br />