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AGREEMENT FOR COMPENSATION BY MINING OPERATION <br />(PIAN -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 oven a structure(s) within 200 feet of this proposed permit boundary. <br />Name / Type of Structure(s): MCI &Dela C`405i,E <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 />'VC <br />F 1vED <br />Other Considerations: <br />X00 20 X 11 <br />C)wisiotl of �zclat�atlt�n, <br />M�ning & saietyl <br />1N WITNESS WHEREOF, this Agreement is made this day of , 2015. <br />Landowner: A4Cf (tmai u"vew S SEA?vicc-S I ksc.. <br />By:94Z"v.e <br />Print Nan e: A(,qj W il,)4.4m <br />Title: h(,w w� psp <br />State of I e x AS ) <br />ss. <br />County of L-), //+45 ) <br />Mine Operator: Su c ents, LLP <br />By: <br />Prin Name: <br />Title: ��,✓�,v f;_r�v <br />The foregoing instrument was acknowledged before me this 1� day of q S , 2015 <br />by % /)A,re as W S10re-�twn/of MU_6,eMvA1.C_a+s _Voices,Tnc. <br />Witness my hand and official seal. *Jimmy Murphree <br />�4? Commission Expires <br />03-13-2016 <br />My Commission expires: !)/)3 r 261(. <br />\Totar u lic <br />Page 1 of 2 <br />