2017-05-09_REVISION - M1997058 (3)

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(y, A I05Z HALL-IRWIN AGGREGATES, LLC 301 CENTENNIAL DRI`'E RECEIVED HILL KEN, CO 80543 (9 0) 587-6906 JUL 1126 i I une 15, 2017 QWW46* n0 pf lWig;&&afwy Reclamation Permit No: M1997058 Name: Baseline Resource Location: 11723 CR 2, Brighton,CO Permit Issued: Feb 12, 1998 This letter is being provided to you as the own r of a structure on or within two hundred (200)feet of a proposed mine site. The State of Colorado, Di ision of Reclamation, Mining and Safety("Division") requires that where a mining operation may aversely affect the stability of any significant, valuable and permanent man-made structure located withirj two hundred (200)feet of the affected land,the applicant shall either: , a) Provide a notarized agreement between the applicant and the Person having an interest in the structure, that the Application is to provide compensation for any damage to the structure; or b) Where such an agreement cannot be reached, the Application shall provide an appropriate engineering evaluation that demonstrates that such structures shall not be damaged by activities occurring at the mining Operation; or c) Where such structure is a u ty, pplicant may supply a notarized letter, on utility letterhead, from the ow� r(s) i0f Y ilit that the mining and reclamation activities, as proposed, will have "no gativ ct" on their utility. (Construction Materials Rule 6.3.12 and Rule 6.4.19& Hard R kJMel !Mining Rule 6.3.12 and Rule 6.4.20) The Colorado Mined Land Reclamation Board("Board")has determined that this form, if properly executed, represents an agreement that com lies with Construction Materials Rule 6.3.12(a), Rule 6.4.19(a)and C.R.S. §34-32-115(4)(d). This fo m is for the sole purpose of ensuring compliance with g the Rules and Regulations and shall not maktent he Board or Division a necessary party to any private I civil lawsuit to enforce the terms of agre or create any enforcement obligations in the Board or the Division. The following structures are located on or wi hin 200 feet of the proposed affected area: 1. Oil/gas well i 2. 3. 4. 5. (Please list addkional structures on a separate page) a a CERTIFICATION The Applicant, Hall-Irwin Aggregates, LLC, �y Bret Hall, as Manager, does hereby certify that PDC Energy Inc. (structure owner) shall be compensated for any damage from the proposed mining operation to the above listed structure(s) located on or within 200 feet of the proposed affected area described within Exhibit A of the Reclamation Permit Application for Baseline Resource, File Number: M1997058.