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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 Poudre Valley REA (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 5J Pit -----------------__— -_---- -- (operation name), <br /> File Number M-2024.032 <br /> This farm has been approred by the Colorado Mined Land Reclamation Board pursuant to its <br /> autlroritl'under the Colorado Land Reclamation Act or the Extraction of Construction Materials and <br /> the Colorado Mined Land Reclamation Act for Hard Rock, Metal, and Designated ruining Operations. <br /> Any alteration or modification to this farm shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY• <br /> Applicant Connell Resources, Inc. Representative Signature <br /> Date7/7eZ Title re- <br /> si Gr� <br /> STATE OF JG h.) <br /> COUNTY OF L �1�1 irs. <br /> o� <br /> The ' • J 'n ac i i' edged re n th'sclay 20 , b <br /> as %t of — — �``' r i� <br /> 41 My Commission Expires: O �' v <br /> No ai ibltc <br /> JENNIFER LINDBLAD <br /> Notary Public <br /> State of Colorado <br /> Notary ID#20144008302 <br /> My Commission Expires 02-21-2026 <br /> Page 2 of 3 <br />