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PERM ITTEE/STRUCTURE OWNER AGREEMENT <br /> Mine: Fox No 1 Clay Pit-M-1977-219 <br /> State of Colorado, Mined Land Reclamation (MLR) law requires the permit applicant(operator/permittee) <br /> to agree to reimburse the owner of any permanent man-made structure(s)within 200 feet of the permitted <br /> mining area, for damage done to the structure(s) as a result of the permitted operation <br /> Summit Brick and Tile Co. believes Constance Demartine&Timothy Hanratty own the following <br /> structure(s), located within 200 feet of the permitted mining area: fence <br /> Summit Brick and Tile Co. agrees to reimburse you for any damage done to the listed structures as a <br /> result of the mining operation. Your acknowledging signature and a notary seal in the spaces provided <br /> below shall satisfy the MLR law requirement. Summit Brick and Tile Company certifies this agreement as <br /> follows: <br /> CERTIFICATION: The Applicant Summit Brick and Tile Co. represented by Matthew R. Welte as COO, <br /> does hereby certify that Constance Demartine&Timothy Hanratty shall be compensated for any damage <br /> from the proposed mining operation to the above listed structure(s) located within 200 feet of the permitted <br /> mining area described in the MLR Permit for the Fox No. 1 Clay Pit. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Permit Applicant: Summit Brick and Tile Co., P.O. Box 533, Pueblo 81003 <br /> Representative: Matthew R. Welte COO-719-542-8278 <br /> KATHLEEN A.CLEMENTI <br /> Signature: Date: �Z s/ZOO IC <br /> STA ETOFCOLOLRADO <br /> NOTARY ID 20144043949 <br /> STATE OF Colorado ) MY COMMISSION EXPIRES NOVEMBER 13,2018 <br /> ss <br /> COUNTY OF Pueblo ) <br /> The foregoing was acknowledged before me this f day of <br /> by Matthew R. Welte as COO of Summit Brick&Tile CO. <br /> Notary Public: '&'I .-�My Commission Expires: <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEDGED BY: <br /> Structure Owner(s): Constance Demartine &Timothy Hanratty <br /> Signature: Date: <br /> Signature: Date: <br /> STATE OF ) <br /> ) ss <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this day of by <br /> Notary Public- My Commission Expires: <br />