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PERMITTEE/STRUCTURE OWNER AGREEMENT <br /> Mine: Native/Pierre Mine-M-1977-321 <br /> State of Colorado, Mined Land Reclamation (MLR) law requires the permit applicant(operator/permittee)to agree <br /> to reimburse the owner of any permanent man-made structure(s)within 200 feet of the permitted mining area, for <br /> damage done to the structure(s) as a result of the permitted operation. <br /> Summit Brick and Tile Co. believes Hector Valle own the following structure(s), located within 200 feet of the <br /> permitted mining area: House, Fence <br /> Summit Brick and Tile Co.agrees to reimburse you for any damage done to the listed structures as a result of the <br /> mining operation. Your acknowledging signature and a notary seal in the spaces provided below shall satisfy the <br /> MLR law requirement. Summit Brick and Tile Company certifies this agreement as follows: <br /> CERTIFICATION: The Applicant Summit Brick and Tile Co. represented by Matthew R. Welte as CEO, does <br /> hereby certify that Hector Valle shall be 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 <br /> Native/Pierre Mine. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEDGED BY: <br /> Permit Applicant: Summit Brick and Tile Co. P.O. Box 533 Pueblo 81002 <br /> Representative: Matthew R. Welte CEO-719-542-8278 <br /> Signature: �ti � ��� Date: S �u <br /> STATE OF Colorado ) <br /> ) Ss <br /> COUNTY OF Pueblo ) <br /> The foregoing was acknowledged before me this d ay of 2020, by <br /> Matthew R.Welte as CEO of Summit Brick&Tile CO. <br /> Notary Commission Expires: f� �z <br /> KATHLEEN A CLEMENTI _P <br /> NOTARY PUBLIC <br /> NOTARY FOR STRUCTURE OWNER STATE OF COLORADO <br /> NOTARY ID 20144043949 <br /> ACKNOWLEDGED BY: MY COMMISSION EXPIRES NOVEMBER 13,2022 <br /> Structure Owner(s): Hector Va - <br /> Signature: r�.-� Date: 'N. <br /> ' <br /> STATE OF _C©lO r(Q db ) <br /> )Ss <br /> COUNTY OF <br /> The forggoin was ac ow ged before me this /Ll day off 20 �, by <br /> I-1 C'(-6f - , — <br /> Notary Publi �C,_�U �iiy Commission Expires: a_ 7 9-1 <br /> 1Ut.U► C.AU.t)RtT1 <br /> NOTARY pU L1 <br /> STATE OF COLORADO <br /> MYOComnn salon TARY ID 200 <br /> MY 2021 <br /> SENT TO STAUCTURF] OWNER VIA CER1'iFIED MAIL 4 70192970000082391424 <br />