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t G1 <br />AGREEMENT FOR COMPENSATION BY MINING OPERATION <br />(MAN-MADE STRUCTURES WITHIN 200 FEET) <br />Colorado State law requires that man-made structures within 200 feet of a mining operation be <br />given special consideration. If the mining operation damages a man-made structure within 200 feet, <br />the mining operator will repair the structure, replace the structure, or compensate the owner of the <br />structure its fair market value. Maps in the vicinity of the proposed mining operation indicate that <br />you own a structure(s) within 200 feet of this proposed permit boundary. RECFiVED <br />Name/ Type of Structure(s): <br />By signing this Agreement, the owner of the structure(s) acknowledges that they have been Rectat, <br />informed of the permit application and agree to the arrangement of repair, replacement, or vF n4 g & safety <br />compensation if the mining operation damages any of their structures as substantiated by proper <br />evidence and documentation. By signing this Agreement, the reining operator acknowledges their <br />responsibility as stated above. <br />Other Considerations: V'�-A <br />T <br />� <br />IN WITNESS WHEREOF, this Agreement is made this tday of 2015. <br />v� , <br />uC vice ne.c <br />Mine Operator: Su tments, LLP <br />By: y: <br />Print acne: Print Naive: cs�gf� <br />Title: <br />State of - n } <br />ss. <br />County of\ <br />The foregoing instrument was acknowledged before me this ! 17�! day of �a 201 S <br />by. as �_.c�eee , t_ of <br />Witness my hand and official seal. <br />CATHERINE lAd3EN4.EE. <br />WrARY PLMW <br />STATE OF COLQRAW <br />My CommissionX12047 <br />Page I of 2 <br />Notary Public <br />