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PERMITTEE/STRUCTURE OWNER AGREEMENT <br /> The Colorado Division of Reclamation, Mining and Safety(DRMS), abiding by the State of Colorado, Mined Land <br /> Reclamation (MLR) Law, requires the permit applicant(operator/permittee)to agree to reimburse the owner of <br /> any permanent man-made structure(s)within 200 feet of the permitted mining area for damage done to the <br /> structure(s) as a result of the permitted operation. <br /> As permittee, L.G. Everist, Inc, believes St.Vrain Sanitation District owns the following structure(s), located <br /> within 200 feet of the permitted mining area: sanitary sewer lines . <br /> L.G. Everist, Inc. agrees to reimburse St.Vrain Sanitation District for any damage done to the structures listed <br /> above as a result of the mining operation. Your acknowledging signature and a notary seal in the spaces <br /> provided below shall satisfy the MLR law requirement. L.G. Everist, Inc. certifies this agreement as follows: <br /> CERTIFICATION: The permittee, L.G. Everist, Inc., represented by Lynn M. Shults, as Regulatory <br /> Manager, does hereby certify that St. Vrain Sanitation District shall be compensated for any damage <br /> from the proposed mining operation to the above listed structure(s) located within 200 feet of the <br /> permitted mining area described in the DRMS Permit for Carbon Valley Resource(M-2001-017). <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Permitee/Applicant: L.G. Everist Inc. 7321 E 88th Avenue Suite 200 Henderson CO 80640 <br /> Representative: J vnn M. Shults, Requlatory Manager, office-303-286-2247 <br /> Signature: CIA Date: <br /> DEBRA ANN THOMPSON <br /> STATE OF Colorado ) NOTARY PUBLIC <br /> ) SS STATE OF COLORADO <br /> NOTARY ID 2DiS403W7 <br /> COUNTY OF Adams ) My COMMISSION EXPIRESOCTOBER07,202o <br /> The foregoing was acknowledged before me this�day of J A1,JU 4 P--y 2017, <br /> by Lynn M. Shults as Regulatory Manager of L.G. Everist, Inc. <br /> Notary Public,, /��`T 'a���' �y Commission Expires: �C'iZ ,G' �fT <br /> a <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEDGED BY: �tl�G k <br /> Structure Owner(s): St. Vrain Sanitation District Contact(print): �4" <br /> Signature:_ +— Date: <br /> STATE OF Cot 0�OS�� ) <br /> ) SS <br /> COUNTY OF ) <br /> � ,- , 2017, <br /> The foregoing was acknowledged before me this _day of_� <br /> by ` <br /> Notary Public y Commission Expires: do` <br /> HEIDI AWN HURTADO <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20164019"ll <br /> CV-DRMS-Amend-StructureLtr-StVrain-Jan20l7.docx My Commission Expires May 20 2020 <br />