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CERTIFICATION <br /> The Applicant, Connell Resources, Inc. (print applicant/company name), <br /> by John Warren (print representative's name), as President (print <br /> representative's title), does hereby certify that CenturyLink(Lumen) (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 Timnath Connell Pit amendment (operation name), <br /> File Number M-1999-050 <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 far Hard Rock, Metal, and Designated Mining Operations. <br /> Any alteration or modification to this form shall result in voiding this forms. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Connell Resources,Inc. Representative Signature <br /> Date C! /Z Title f�rrsi�/ <br /> STATE OF O ) <br /> ss. <br /> COUNTY OF /1r Mec ) <br /> The re of vy ackn wledged fo e me is 1 ay of 2I • <br /> V0 N -Yremas t- '( cj t- of n�� ,� r� �(C�s• rl� . <br /> My Commission Expires:_ - �,- <br /> Notary Public <br /> JENNIFER LINDBLAD <br /> Notary Public <br /> State of Colorado <br /> Notary ID#20144008302 <br /> My Commission Expires 02-21-2026 <br />