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CERTIFICATION <br /> The Applicant, Fremont Paving and Redi Mix, Inc. (print applicant/company name), <br /> by John P. Ary (print representative's name), as President (print <br /> representative's title), does hereby certify that Kent Ricken (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 Two Rivers Gravel Pit (operation name), <br /> File Number M-1998-038 . <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 /> 1 <br /> ACKNOWLEGFD)�Y, I \ <br /> Applicant IJ � Representative Name <br /> Date oZ '� Title pyt,51 pit/t _- <br /> STATE OF 6 kAk ) <br /> ss. <br /> COUNTY OF awe ) <br /> The foregoing was acknowledge before me this y-day of , 20. , by <br /> \ hrik. Pwi--as a3i AI of = `X the . <br /> My Commission Expires: z jh,o o oa(Q <br /> tar ublic <br /> JODI D SCHREIBER <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20064001792 <br /> MY commjSS3Ot4 ExPiRES OCTOBER 6,2026 <br />