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PO, 14Zig,b71 <br /> • 1 <br /> RECEIVED OCT 3 0,2017 <br /> PERMITTEE/STRUCTURE OWNER AGREEMENT %-C 0 r�.51 <br /> M&G Pit Permit#M-1985-079 <br /> 0 Resafeil <br /> State of Colorado,Mined Land Reclamation(MLR)law requires the permit applicant(operator/permittee)to agrej& <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 and Sanitation District shall own the following <br /> structure(s),located within 200 feet of the permitted mining area Non-potable Water,Fence,Hydrants. <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 rind Sanitation District 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 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 KATHRYN A DAYMUT <br /> NOTARY PUBLIC <br /> Signature. Date: '0,b I C l STATE OF COLORADO <br /> f NOTARY ID:19964015382 <br /> STATE OF Colorado )•CtMY COMMISSION EXPIRES APRIL 1,2018 <br /> )ss <br /> COUNTY OF Denver ) l` <br /> The foregoing was acknowledged before me this day ofDC7CfI g---- ,2017,by Joseph M. <br /> O'Dea as the Manager of Mann Lake Holdings,LLC. <br /> Notary Publi • 1 <br /> Atm" A Ili ._A. My Commission Expires: ` — ' 61-01 S <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEDGED BY: , , p -�- lJIA <br /> Structure Owner(s): z- 4 r (•lj I'"' �; Contact name(print): v7 rr1 / <br /> Signature: p,iDate: /0 27 7 <br /> SANDRA JOAN SCHRAWDER <br /> STATE OF t (D i�Cl do ) NOTARY PUBLIC <br /> )ss STATE OF COLORADO <br /> COUNTY OF MO 1 ,�J ) NOTARY 10 20094004109 <br /> MY COMMISSION EXPIREFRUARY 9,2021 <br /> The foregoing was acknowledged before me this 17 ► day of ?J�2017,by <br /> .j.±_t___ <br /> Notary Public �,�? �i�.� � � � My Commission Expires:< <br /> //)`, -J <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL 1i -74 1 I cs-a 000b ISO O , FS-V <br />