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CERTIFICATION <br /> The Applicant, JPA Properties uf, _ (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 Debraha Deluca (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 291 Pit (operation name). <br /> File Number M-1987-195 . <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br /> authority under the Colorado Lund 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 _Pick . 'vcsp ,t±if5 L. Representative Name <br /> kDate IlTitle <br /> STATE OF to I c r-r ) <br /> )ss. <br /> COUNTY OFY ) <br /> The foregoing was acknowledged before me this 1S day of�1r 2O07 by <br /> �hh P.-AN_rs.1 as Ma, h�tbtr of _�1 IIL • <br /> z <br /> My Commission Expires: l 0 )(picD,te__ <br /> of v Public <br /> Arrr— <br /> STATE OFCC;..ci'; ro <br /> ; p( D 2Ci:•:.-001,p2 <br />