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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. <br />Name / Type of Structure(s): <br />By signing this Agreement, the owner of the structure(s) acknowledges that they have been <br />informed of the permit application and agree to the arrangement of repair, replacement, or <br />compensation if the mining operation damages any of their structures as substantiated by proper <br />evidence and documentation. By signing this Agreement, the mining operator acknowledges their <br />responsibility as stated above. <br />Other Considerations: <br />1� <br />pivist � "'3 <br />IN WITNESS WHEREOF, this Agreement is made this day of , 2015. <br />Landowner: Mine Operator: Sundance Investments, LLP <br />By: <br />Print Name: <br />Title: <br />State of <br />) ss. <br />County of <br />By: <br />Print Name: <br />Title: <br />The foregoing instrument was acknowledged before me this <br />by <br />Witness my hand and official seal. <br />My Commission expires: <br />as <br />Page 1 of 2 <br />day of 92015 <br />of <br />Notary Public <br />