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CERTIFICATION <br /> The Applicant, Siete Inc. (print applicant/company name), <br /> by Baxter Kirkland (print representative's name),as President (print <br /> representative's title),does hereby certify that Buzz Williams (structure owner)shall <br /> be compensated for any dem:g �.� •��Y: _ __,.�._._� _ _�._�_ :>__ »,�v.. '..:._a� � �r- _�..� <br /> located on or within 200 feet of the proposed affected area described within Exhibit A,of the Reclamation <br /> ^ci"-- `Application for Siete INc. <br /> (operation name), <br /> File Number M..2023_005 <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br /> authority under the Colorado Len,'pni." .' .- 4.1Oi....6.. T.v.rw ..I•!'n........ ,.. >a :./ ....� <br /> the Colorado Mined Land Reclamation Act for Tiara Roci,irieuei, ems iiesignuseu mining',perutwns. <br /> Any alteration or moderation to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicar�t. i i Representative Name tip" /642 , <br /> Date 'z � Title <br /> STATE OF Col11rGci® ) <br /> )ss. <br /> COUNTY OFT RA 4-61 Q ) <br /> The foregoing was acknowledged before me this.Vq day of ,20, ,3,by <br /> -EcXkeW• kt-I to, as --Pre5i Qri_t __ of 4t.t.ti . ..__ <br /> (- I <br /> A/140.[ My Commission Expires:-{=�$'.�Q�(� <br /> Notary PublicRA a <br /> aYPURL.441 <br /> ";i: <br /> • r. a:!:d:r x! (v2,2026 <br />