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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 Larimer County (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 Lund Reclamation Act for the Extraction of Construction Materials anti <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 firm. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Connell Resources,Inc. Representative Signature ''�� <br /> Date 5 Zy Title get''�e �` <br /> STATE OF (0) <br /> ss. <br /> COUNTY OF a; <br /> oregoin w ackno ledged b re me thi � d �� 11 <br /> ay ohU20 _ b <br /> as r-re1neRi"--' of n,)1rrA Wei) AG <br /> My Commission Expires: cr-D._-g-t ' (1)'- '1c) <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 /> �l; <br />