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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 United State Post Office _(structure owner)shall <br /> be compensated for any dam;;:.-. frc::: :p; - --a -. - :t _4c:1- c c._;;-: -4--`- <br /> a� r-�r� �a ter= .--...,.., <br /> located on or within 200 feet of the proposed affected area described within Exhibit A,of the Reclamation <br /> Permit Application for Siete INc. _ (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 1 n«d Fonlnwnf:n« A":liar#i.n Fs.nh ...s:..« ^drrs......4.....4.... 11.I..,....:..1,.,....I <br /> the Colorado Mined Land Reclamajun Aci for Hard siocic,Metal,and uesig..K.eu nee ung uperauons. <br /> Any alteration or modification to this form shall result in voiding this form. <br /> NOTARY FOR PERMIT T .:'; <br /> ACKNOWLEGED B : <br /> Applicant rJ <br /> ____ Representative Name � �' ((--A/taatiNtat <br /> Date ern- fiti i p Title PST, 0fr <br /> STATE OF C_010 p._) <br /> )ss. <br /> COUNTY OF PIA.dot Q_ ) <br /> The foregoingwas acknowledged before me this 21 day of 4prii __ , 2003 by <br /> •13X+ei Kir k i t ,d _as __ r_.25 i Ci e.ra& of 'i_Q:p t :L nc-• <br /> _Tettat.,ar.. ,F.,,,,i4.„6__ <br /> 4 ---- - My Commission Expires: c)8I�®gi .(o <br /> Notary Public <br /> BONNIE J. RAMOS <br /> NOTARY PUBLIC <br /> State ofttCg 09/26b <br />