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CERTIFICATION <br /> The Applicant, JPA Properties(,, (print applicant/company name), <br /> by John P. Ary (print representative's name), as Managing Member (print <br /> representative's title),does hereby certify that Zebulon McCain (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 Buena Vista Pit (operation name), <br /> File Number M-1977-196 . <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 3PA-4-b f rE;t� Representative Name <br /> Date 8 J 1610JTTf' Title <br /> STATE OF l' , ip, ) <br /> ) ss. <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this 1,C day of , 200.a, by <br /> \.)Akk Q.ANAA. as V1iva leV' of 14 tpt�tkiQS LLr . <br /> '1 My Commission Expires: `d/(o/1--�° <br /> Public <br /> f . <br /> NCITV:1FUe3LIC <br /> Slrf;a ' OF COLO:DO <br /> Pat-TAR(Ili 2006:001! '2 <br /> MY Co:vimisioN E-xPift.s cCTOFTR 5.20"6 <br />