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CERTIFICATION <br /> The Applicant, Connell Resources, Inc. (print applicant/company name), <br /> John Warren President nit <br /> (print representative's name), as .(}» <br /> representative's title), does hereby certify that O'Neill, Patrick J (structure owner) shall <br /> be compensated for any damage irom 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 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 il!aterials 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 /> Date L y -- — — Title <br /> STATE O ) <br /> ss. <br /> COUNTY OF <br /> Tl > ego' r w s ackr wledgec} e s re ne thi ay of <br /> y as of Q , Ia.C...-. <br /> My Commission Expires: _ L__U ' <br /> Notary Pu <br /> DBLAD <br /> blic <br /> lorado <br /> 44008302 <br /> Lillilli <br /> res 02-21-2026 <br /> Page 2 of 3 <br />