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PERMITTEE ! STRUCTURE OWNER AGREEMENT <br /> The Colorado Division of Reclamation, Mining and Safety(DRMS), abiding by the State of Colorado, Mined Land <br /> Reclamation (MLR) Law, requires the permit applicant/operator to agree to reimburse the owner of any permanent <br /> man-made structure(s)within 200 feet of the permitted mining area for damage done to the structure(s)as a result <br /> of the permitted operation. <br /> L.G. Everist, Inc. operates the Firestone Gravel Resource, DRMS Permit M-1996-052, a sand and gravel mine. <br /> Jonna Hierro owns the following structure(s), which are located within 200 feet of the permitted area: <br /> - Three wire fence, House&garage <br /> L.G. Everist, Inc. agrees to, and certifies this agreement as follows: <br /> The permittee, L.G. Everist, Inc., does hereby certify that the above-named Owner shall be compensated for <br /> any damage to the above-listed Structure(s),which is located within 200 feet of the permitted area,as a result <br /> of the mining operation known as Firestone Gravel Resource, DRMS Permit M-1996-052. <br /> A signature by Jonna Hierro and a notary seal in the spaces provided below shall satisfy the MLR law <br /> requirement A copy of the signed notarized agreement shall be kept by L.G. Everist and the Structure Owner. <br /> NOTARY FOR PERMIT APPLICANT NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEDGED BY: ACKNOWLEDGED BY: <br /> Permittee: L.G. Everist, Inc. Owner(s): a"e /1� _�� el_>4 U <br /> Mail Address 7321 E 88th Ave., Suite 200, Mail Address: 3 <br /> Henderson, CO 80640 L6y1q1n6'17'1 <br /> Contact: Lynn M. Shults, Regulatory Mqr. Contact(if different than owner): <br /> 303-286-2247 <br /> Signature: I Signature: <br /> Ok <br /> Date: r�) —211-1— Zil Date: <br /> STATE OF Colorado ) STATE OF Colorado ) <br /> ss ss <br /> COUNTY OF Adams ) COUNTY OF Ue _ ) <br /> The foregoing was acknowledged before me this The regoing was a owledged before me th's <br /> 0 day of 1W NA , 2019, _ _dav of N- ,201 <br /> by Lynn M. Shults as Regulatoo Manager of L.G. by DAbAL 4.aj of - <br /> Everist, Inc. A. <br /> Notary Public:, /,��// <br /> /At:'C'� ���.✓ Notary Public: - <br /> My Commission Expires:CrZ,4? My Commission Ex fires: g <br /> KATHERINE PAYNE <br /> DEMA AM T►dOUPSM NOTARY PUBLIC <br /> aoTAWtc STATE OF COLORADO <br /> Z.- Environment, /i c. -St NOTARY ID 20094015417 <br /> My coax MSM s OC R 07,mm <br /> MY COMMISSION EXPIRES MAY 31,2021 <br />