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CERTIFIC A t'1Or; <br /> Fremont Paving &Redi-Mb( (print applicandcompany name), <br /> The Applicant, -- -- <br /> h,, John Paul Ary (print representative's name),as President _(print <br /> representative's title),does hereby certify that Black HiEnergy (structure owner)shall <br /> be compensated for any damage from the proposed mining operation to the above listed structures) <br /> located on or within 200 feet of the proposed affected area described within Exhibit A,of the Reclamation <br /> Two Rivers Pit _(operation name), <br /> Permit Application for _. - - --- <br /> File N umber M-1998.03{( <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 /> ['AR`t' 1,01t PERM!!t At°1'IA('AN t <br /> �' NO LIEGED BY: <br /> Applicant `- .-"i''� J);„: - Representative Name �l` r� i-L'' t----- <br /> Date "t r' !:' L Title- — <br /> STATE OF ' i)13�da :, a <br /> ) ss <br /> COt'NiY OF_ 'A. <br /> File fotegouts was acknowledged before mc this clary of 'VA'.onkt,:-4. 20 , by <br /> . A a -; 1-6v14.1%._.„ t �� ,• .��tll' �v�• s `'.�; t <br /> 4-= of <br /> int My Commission Expire, J ;i? 4..)" <br /> '''owry (tub!ic <br />