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3asl"a2ted71 <br /> RECEIVED OCT 3 0 2091 <br /> PERMITTEE/STRUCTURE OWNER AGREEMENT DEC 0 4 201 <br /> M&G Pit Permit# M-1985-079 eclaR,ation, <br /> v;�>ion- safety <br /> State of Colorado,Mined Land Reclamation(MLR)law requires the permit applicant(operator/permittee)to agree to <br /> reimburse the owner of any permanent man-made structure(s)within 200 feet of the permitted mining area for damage done <br /> to the structure(s)as a result of the permitted operation. <br /> Mann Lake Holdings LLC.believes South Adams County Water&Sanitation District shall own the following <br /> structure(s),located within 200 feet of the permitted mining area Fence, Waterline and Appurtenances. <br /> Mann Lake Holdings agrees to reimburse you for any damage done to the listed structures as a result of the mining operation. <br /> Your acknowledging signature and a notary seal in the spaces provided below shall satisfy the MLR law requirement. Mann <br /> Lake Holdings certifies this agreement as follows: <br /> CERTIFICATION: The Applicant Mann Lake Holdings LLC represented by Joseph M.O'Dea ,as the Manager <br /> does hereby certify that South Adams County Water&Sanitation District shall be compensated for any damage from <br /> the proposed mining operation to the above listed structure(s)located within 200 feet of the permitted mining area <br /> described in the MLR Permit for the M&G Pit. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Permit Applicant:Mann Lake Holdings LLC.2027 W.Colfax Avenue,Denver CO 80204 <br /> Representative: Joseph M.O'Dea,Manager,303.562.2000 <br /> JESSICA A.RAY <br /> PUBLIC <br /> Signature: Date: 1011j21 STATEARY ATE OF COLORADO <br /> NOTARY ID 2008403.5981 <br /> STATE O Colorado ) MY MISSION EXPIRES OCTOBER 1S,220 <br /> )ss <br /> COUNTY OF Denver ) (t,^ U//�� <br /> The foregoing was acknowledged before me this 111 day of dtber ,2017,by Joseph M. <br /> O'Dea as the Manager of Mann Lake Holdings,LLC. <br /> • <br /> _! x <br /> Notary Publi;� t.11 t�� t . a <br /> My Commission Expires: � ��.?' �yU <br /> / <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEDGED BY: ' � <br /> Via.. P� <br /> Structure Owner(s): . \ C Contact name(print): LJi wljoici <br /> Signature: Date: /a -7'7 /7 . <br /> STATE OF (e/61'0 D ) <br /> COUNTY OF / 111 > )ss SANDRA JOAN SCHRAWDER <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> r� <br /> The foregoing was acknowledged before me this �� -4-) day of /T'I,2017, y NOTARY ID 20094004109 <br /> MY COMMISSION EXPIRES FEBRUARY 9,2021 <br /> i/ <br /> Notary Public%/)'j,�Y/�[ 91, Zl�(-�3�`"'1' '.?(,t 4—,) My Commission Expires: 41/61(140/ <br /> I <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL it <br />