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(r1 l RB,o?y' <br /> RECEIVED NOV 07 2017 --, <br /> PERMITTEE/STRUCTURE OWNER AGREEMENT DCC D 4 7.011 <br /> M&G Pit Permit#M-1985-079 <br /> -1 n'n tion, <br /> State of Colorado,Mined Land Reclamation(MLR)law requires the permit applicant(operator/permittee)to agree to ,iety <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 stnicture(s)as a result of the permitted operation. <br /> Mann Lake Holdings LLC.believes Adams County shall own the following structure(s),located within 200 feet of the <br /> permitted mining area Traffic Lights. <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 Adams County shall he compensated for any damage from the proposed mining operation to the <br /> above listed structure(s)located within 200 feet of the permitted mining area described in the MLR Permit for the M&G <br /> Pit. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Permit Applicant:Mann Lake Holdin l s LLC 2027 W.Colfax Avenue Denver CO 80204 <br /> Representative: Joseph M.O'Dea,Manager,303.562.2000 KATHRYN A DAYMUT <br /> NOTARY PUBLIC <br /> Signature: Date: -1(),(0` \ STATE OF COLORADO <br /> NOTARY ID:19964015382 <br /> STATE P Colorado ) tMY COMMISSION EXPIRES APRIL 1,2018 <br /> !,' )ss <br /> COUNTY OF Denver ) <br /> The foregoing was acknowledged before me this "0 day of(DL., L) ,2017,by Joseph M. <br /> O'Dea as the Manager of Mann Lake Holdings,LLC. <br /> Notary Pubh .4 <At�� A. �1 .i . My Commission Expires: <br /> -1 - 4-OI <br /> 1 <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEDGED BY: <br /> Structure Owner(s): � C i i2 1j Contact name(print) dog 9_21P 5 <br /> A --� <br /> Signature e�� �' Date . <br /> [i0 <br /> STATE OF at-el do ) <br /> COUNTY OF /196/4/n7S' )ss <br /> (u <br /> The foregoing was acknowledged before me this 1, T� day of--- 02./1/114-20 17, w ---- ---r}--^- ----,- -�'' <br /> ELIZABETH A.ALBRIGHT S <br /> 3 NOTARY PUBLIC <br /> ( 2 /, ZaL(S STATE OF COLORADO <br /> / NOTARY ID 19974003689 <br /> MY COMMISSION EXPIRES FEBRUARY 27,2021 <br /> Notary Public: 53My Commission Expires: o2/iz7/.2/ <br /> APPROVED AS TO FORM <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL # 1 iiI ;- r `i-J-0 co1oO 1 SO ?&530 COU ATTOR EY <br />