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CERTIFICATION <br />The Applicant, RIVERSIDE AGGREGATES, LLC (print applicanticompany name), <br />by RUDY TORRES (print representative's name), as OWNER (print <br />representative's title), does hereby certify that EhURAIE Lim1rFa fJ 11F,cs1V,1P (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 SHARP PIT # 2 <br />File Number M- 2013 023 <br />(operation name), <br />This form has been approved by the Colorado Mined Land Reclamtion 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 mod ficadon to this form shall result in voiding this forns <br />NOTARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant�U S�00/ -Pies LL Representative Name WILAY %p,C,Qes <br />Date f'inn'1 A % / D, Aol -5 Title <br />STATE OF <br />C�DAORAbQ ) ` <br />) ss. <br />COUNTY OF ewT ) <br />The foregoing was acknowledged before me this /D -t# day of 41 20 L3, by <br />u A Y Toy e Fs as ,e /!it b ofi yPesiQErr�� frs, LG C . <br />My Commission Expires: 41- <br />Notary Public <br />V" A. MORGAN <br />Notary Pubpc <br />State of Colorado <br />