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CERTIFICATION <br /> The Applicant,Asphalt Specialties. Co.. Inc..by Daniel W.Hunt,as President,does hereby certify <br /> that Denver Water shall be compensated for any damage from the proposed mining operation to <br /> the above listed structure(s) located on or within 200 feet of the proposed affected area described <br /> within Exhibit A, of the Reclamation Permit Application for Chavers Mining Resource, File <br /> Number M-2015-030. <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 <br /> Materials and the Colorado Mined Land Reclamation Act for Hard Rock, Metal, and <br /> Designated Mining Operations. Any alteration or modification to this form shall result in <br /> voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Representative Name Pc,n'lei W. N(Ayr)" <br /> Date Wove n,foe.ya. 17,,x- Title Pt�CC25rclert÷ <br /> STATE OF (-00Kadc) ) <br /> ) ss. <br /> COUNTY OF A of c4'y11 s ) <br /> The foregoing was acknowledged before me this 17°'day of /Vo F r, e,,., 20,z; , by <br /> Tr) II / <br /> fi el,e_ I IN +' �u" as '�jQ :t,,� it='�i ' of 4,21,Q !� C-. . <br /> My Commission Expires: -110-a=,:: '`t ,.-'c '(/ <br /> Notary Public <br /> JAN NELSON <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 19994030527 <br /> My Commission Expires April 29.2024 <br />