2016-05-10_PERMIT FILE - M2010049 ‎(2)‎

• Permit No: M2010049
• IBM Index Class Name: Permit File
• Doc Date: 5/10/2016
• Doc Name: Adequacy Review Reply
• From: Varra Companies, Inc.
• To: DRMS
• Email Name: PSH
• Media Type: D
• Archive: No

Varra Companies, Inc. JAN 1 31016
Office of Special Projects
8120 Gage Street Frederick,Colorado 80516 Telephone[phone] Fax[phone]
Statement of Understanding
Landowner of Adjacent Structure Statement: Our notarized signature below testifies we
have been provided with and opportunity to review:
1) a Stability Analysis Report pertaining to the proposed Western Sugar Reclamation Land
Development Project—Regular Impact(112)Permit Application M-2010-049;and,
2) a Map (Exhibit C-I) showing the approximate relationship of our property and the potential
for any qualified significant, valuable and permanent man-made structure(s), which may
occur within 200 feet of lands affected within the proposed Parcel 122 - Resource Development
Project—Regular Impact(112)Permit Application M-2010-049.
Upon review of the available materials;
And understanding the relationship of any significant, valuable and permanent man-made structures
under our ownership and which may stand within 200 feet of lands affected within the proposed Western
Sugar Reclamation Land Development Project—Regular Impact(112)Permit Application M-2010-049;
Further, by our signatures, as notarized below, we concur that planned activities detailed in the
application for permit M-2010-049; do not impact our qualified significant, valuable and permanent
adjacent man-made structures; and to assure you that in the unlikely event damage occurs to your
structures as a direct result of our active operations, it will be compensated for, consistent with
established law.
Signature of Adjacent Landowner Date
(offhi /14 112t
Print Name
7.
State of (,c_. (1, )
)ss.
County of Lt ?ISI •
)
The foregoing instrument was acknowledged before me this i day of _ . aIle d-
by for l:pc'
). Title
Company or Corporation �;
N
Notary Public
2