Laserfiche WebLink
PERMITTEE/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)to agree <br /> to roimburco rho ownor of any pormanont man-made atruMuro(a)within 200 feat of the per nittod mining area,for <br /> damage done to the structure(s)as a result of the permitted operation. <br /> Summit Brick and Tile Co. believes Bernard &Jacqulin Elliott own the following structure(s), located within 200 <br /> feet of the permitted mining area: House, out buildings, Fences,water well <br /> Summit Brick and Tile Co. agrees to reimburse you for any damage done to the listed structures as a result of the <br /> mining operation. Your acknowledging signature and a notary seal in the spaces provided below shall satisfy the <br /> MLR law requirement. Summit Brick and Tile Company certifies this agreement as follows: <br /> CERTIFICATION: The Applicant Summit Brick and Tile Co. represented by Matthew R. Welte as COO, does <br /> hereby certify that Bernard &Jacqulin Elliott shall be compensated for any damage from the proposed mining <br /> operation to the above listed structure(s)located within 200 feet of the permitted mining area described in the MLR <br /> 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 /> Signature: &dg& Ra Date: ST F YgNOr R 4.C4 <br /> STATE OF Colorado ) S H v F040 Z O F � <br /> ss <br /> COUNTY OF Pueblo <br /> / 9 <br /> The foregoing was acknowledged before me this day of ,ems , 201 9 <br /> Matthew R. Welte as COO of Summit Brick&Tile CO. <br /> Notary Publi e�'Z2 My Commission Expires: <br /> NOTARY FOR STRUCTURE OWNERS <br /> ACKNOWLEDGED BY: <br /> Structure Owner(s): Bernard Elliot&JacQulin Elliott <br /> Signature: Date: <br /> Signature: Date: <br /> STATE OF ) <br /> )ss <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this day of , 2017, by <br /> Notary Public: My Commission Expires: <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL # 70102780000220634572 <br />