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CERTIFICATION <br /> The Applicant, Mid-States Materials, represented by Cole Andersen, as Senior Vice President, <br /> does hereby certify that John W Craig shall be compensated for any damage from the <br /> proposed mining operation to the above listed structure(s) located on or within 200 feet of the <br /> proposed affected area described within Exhibit A, of the Colorado Mined Land Reclamation <br /> Board Reclamation Permit Application for the Limon Sand&Gravel Resource. <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its authority under <br /> the Colorado Land Reclamation Act for the Extraction of Construction Materials and the Colorado Mined Land <br /> Reclamation Act for Hard Rock, Metal, and Designated Mining Operations.Any alteration or modification to <br /> this form shall result in voiding this form. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Representative Name <br /> Date Title <br /> STATE OF ) <br /> ) ss. <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this day of , 20 ,by <br /> as of <br /> My Commission Expires: <br /> Notary Public <br /> 2 <br />