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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 TDS Telecom (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 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 /> Applicant Connell Resources, Inc. Representative_Signature -� <br /> DateV/2../2,/ Title -4..s'C .f <br /> STATE OF COI-era-J-0 <br /> COUNTY OF 1,�� <br /> he fpreg�oin <br /> cY I acknowl dged for e t is ay of <br /> 30 <br /> i`�i y <br /> asL of K , trr <br /> y Commission Expires: Dd - t -dU `0 <br /> ary Public <br /> JENNIFER LINDBLAD <br /> Notary Public <br /> State of Colorado <br /> Notary ID#20144008302 <br /> My Commission Expires 02-21-2026 <br /> 2/3 <br />