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Varna Companies, Inc. <br />Office of Special Projects <br />8120 Gage Street Frederick Colorado 80516 Telephone (303) 666 -6657 Fax (303) 666 -6743 <br />Statement of Understanding <br />Landowner of Adjacent Structure Statement: Our notarized signature below testifies we <br />have been provided with and opportunity to review: <br />1) a Stability Analysis Report pertaining to the proposed Varra- Coulson Resource Project - <br />Regular Impact (112) Permit Application M- 2013 -064; and, <br />2) a Map showing the approximate relationship of our property and the potential for any <br />qualified significant, valuable and permanent man -made structure(s), which may occur <br />within 200 feet of lands affected within the proposed Varra- Coulson Resource Project - Regular <br />Impact (112) Permit Application M- 2013 -064. <br />Upon review of the available materials; <br />And understanding the relationship of any significant, valuable and permanent man -made structures <br />under our ownership and which may stand within 200 feet of lands affected within the proposed Varra- <br />Coulson Resource Project - Regular Impact (112) Permit Application M- 2013 -064; <br />Further, by our signatures, as notarized below, we concur that planned activities detailed in the <br />application for permit M -2013 -064; do not impact our qualified significant, valuable and permanent <br />adjacent man -made structures; and to assure you that in the unlikely event damage occurs to your <br />structures as di ult of our active operations, it will be compensated for, consistent with <br />actahliclharl w <br />t Landowner <br />/0 - l -7- ,2013 <br />Date <br />Print Name <br />��PpTA9 s�9 <br />State of <br />�i <br />ss. Q: 7-x-0 <br />County of <br />O <br />UBO <br />0, �0 <br />The foregoi instrument was acknowled ed before me this <br />2013, by 9- VS, - x <br />- LI - , & 0A �Q\W\A,i povrL). ,Ti le <br />Company or Corporation <br />Notary Public <br />c)'C -\ ",\,:', t- <br />for <br />My Commission expires: MW w 1 <br />N <br />