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CERTIFICATION <br /> The Applicant, Sunroc Corporation (print applicant/company name), <br /> by Mark Wimmer (print representative's name), as Vice President, Construction (print <br /> representative's title), does hereby certify that Qwest Communications, inc/Centuryiink(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 20 Road Gravel Pit (operation name), <br /> File Number M-2005-061 <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: _ / <br /> Applicant Sunroc Corporation Representative Name `�` <br /> Date 2— .2 Ste— -)).2 Title Vice President, Construction <br /> STATE OF a Jpi- ) <br /> ss. <br /> COUNTY OF IA-�x-� ) <br /> The foregoing was acknowledged before me this 24 day of , 20 L5y <br /> Mark Wimmer as Vice President, Construction of Sunroc Coiporation . <br /> . �/ My Ql /z3 �zf <br /> � Commission Expires: / <br /> o . 'u: is / 11 <br /> y` AN -MA ORFFF�� My�fmE18abnUEXPN <br /> O <br /> ,:. uo,,,, 'b ."16572 <br />