2015-10-13_REVISION - M2004017 - Laserfiche WebLink

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P RM�EE//STRUCTURE OWNER AGREEMENT State of Colorado, Mined Land Reclamation (MLR) law requires the permit applicant (operator/permittee) to agree to reimburse the owner of any permanent man-made structure(s) within 200 feet of the permitted mining area for damage done to the structures) a5 8 resit Of the permitted onemtinn. Granby Sand & Gravel believes Joseph & Tina Haines owns the following structure(s), located within 200 feet of the permitted mining area: 3 strand wire fence . Granby Sand & Gravel LLC. agrees to reimburse you for any damage done to the listed structures as a result of the mining operation. Your acknowledging signature and a notary seat in the spaces provided below shall satisfy the MLR law requirement. Granby Sand & Gravel certifies this agreement as follows: CERTIFICATION: The Applicant, Granby Sand & Gravel LLC, represented by Todd Hammedund, as Manager, does hereby certify that Joseph & Tina Haines shall be compensated for any damage from the proposed mining operation to the above listed structure(s) located within 200 feet of the permitted mining area described in the MLR Permit for the Kattenburg Mine (M-2004-017). ACKNOWLEDGED BY: Permit Applicant: Grar Representative: Todc Signature: STATE OF COLORADO NOTARY FOR PERMIT APPLICANT Date T//,* ) ss. 1 COUNTY OF GRAND ) Lt tH goinged before me this day of 2015, by Aa r f Granby Sand &Gravelj- M Commission Expires: -/ `Cf NOTARY Co Notary Pub is y STATE OF Cgog�ggp1g272 NOTARY ID Feb i8� 2018 NOTARY FOR STRUCTURE OWNER M ACKNOWLEDGED BY: i ") ,-,, Structure Signature: Date: / !o /-/1 - �Date: / — STATE OF CAft'O kDO ) floricla._ ) ss. COUNTY OF-6RAi+1p ) rhe foregoing was acknowledged before me this �� day of . 2015, by (I LI -A, LLES'LLD My Commission Expires: Nota Public CHARLENE DOW Notary Public • State of flori4a * ••. My Comm. ExPirh Mar 6, 2011 C,omf"Isslon M EE $54115 •,..`;;,.n•` - Bonded ihtoWh Nibaul wl y LLC Kattenburg Pit- M-2007-014