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CERTIFICATION <br /> The Applicant, Mid-States Materials, LLC (print applicant/company name), <br /> by Michael Dee Schirmer (print representative's name), as Executive Vice-President (print <br /> representative's title), does hereby certify that Arkansas Valley Ranch, LLC(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 Ordway Pit (operation name), <br /> File Number M-2006-054 <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: 72./f6.) Ji k <br /> Applicant A01.S471QS 47e,)04.6 r JJC Representative Name Ae-)ue 2 OC'e 5c-tl i r/77P/- <br /> Date 7 3o -.70 a V Title fxecq',i'r Pice -Preode,--) <br /> STATE OF ' n3Ct5 ) <br /> ) ss. <br /> COUNTY OF , ) <br /> The foregoing was acknowledged before me this SO'day of 1,Sytisittu, 20 , by <br /> MiCfr el Dee Schirmer as exee thvz Vice PeescdJ of M,d-ST TES Mcrrres&1s,UC . <br /> IbiLul ,utwsit„ l 1 <br /> My Commission Expires:ap otO a0o�7 <br /> Notary Public <br /> Iill, Valerie Slaughter <br /> LNOTARY PUBLIC <br /> STATE OF KANSAS <br /> AY APPT l.XP <br />