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PERMITTEE/STRUCTURE OWNER AGREEMENT <br /> M&G Pit Permit#M-1985-079 <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 Michael D and Donna J Gentry shall own the following structure(s),located within <br /> 200 feet of the permitted mining area Residence,Fence. <br /> Mann Lake Holdings agrees to reimburse you for any damage done to the listed structures as a result of the mining <br /> operation.Your acknowledging signature and a notary seal in the spaces provided below shall satisfy the MLR law <br /> requirement. Mann 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 Michael D and Donna J Gentry 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 Permit <br /> 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 JESSICA A.RAY <br /> NOTARY PUBLIC <br /> Signatur . Date: (O(LO GIO I l STATE OF COLORADO <br /> NOTARY ID 20084035981 <br /> MY COMMISSION EKES OCTOBER 15,2020 <br /> STATE 0 Colorado ) <br /> )ss <br /> COUNTY OF Denver ) //,^, <br /> The foregoing was acknowledged before me this (124:16 day of QCid ,2017,by Joseph M. <br /> O'Dea as the Manager of Mann Lake Holdings,LLC. <br /> Notary Pu AM. A A _ C My Commission Expires:Q z(tbe.c Ig d6 <br /> 01-6 <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEDGED BY: <br /> Structure Owner(s): Contact name(print): <br /> Signature: Date: <br /> STATE OF ) <br /> )ss <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this day of ,2017,by <br /> • <br /> Notary Public: My Commission Expires: <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL # <br />