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PERM ITTEE/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 Barbara Angela Britton own the following structure(s), located within 200 feet <br /> of the 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 Barbara Angela Britton 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 <br /> Permit for the 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: 8 Dater <br /> STATE OF Colorado ) <br /> ) SS <br /> COUNTY OF Pueblo ) <br /> The foregoing was acknowledged before me this day of 2020, by <br /> Matthew R. Weite has CEO of Summit Brick &Tile CO. <br /> Notary Public;/`��` "`ti'� 4 my Commission Expires: /J'� 1�'-2-��"W <br /> KATHLEEN A CLEMENTI <br /> NOTARY PUBLIC <br /> NOTARY FOR STRUCTURE OWNER STATE OF COLORADO ' <br /> NOTARY ID 20144043949 <br /> MY COMMISSION EXPIRES NOVEMBER 13.2022 <br /> ACKNOWLEDGED BY: _ <br /> Structure Owner(s): Barbar• Angela Britton _- <br /> Signature: Date: <br /> STATE OF (,6lcf'C4- ) <br /> ) SS <br /> COUNTY OF <br /> The foregoing was acknowledged before me this q day of M(AA4 --, 20-?0 , by <br /> tea, 6C' - h A-n <br /> Notary Public: My Commission Expires: yN J ate-! <br /> HEATHERS PADILLA <br /> N01ARY OUM IC <br /> S1ATE OF COLORADO <br /> NOTARY IO 20134U02618 <br /> MY COMMISSION EXPIRES JANUARY 24 2021 <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL #! 70181130000165522831. <br />