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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 Housing Authority of Pueblo own the following structure(s), located within 200 <br /> feet of the permitted mining area: House(1213 Rupple St) <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 Housing Authority of Pueblo 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: ��z (,`�LLI' �L . �� Date: <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.Welte as CEO of Summit Brick &Tile CO. <br /> -Z� <br /> Notary Public GS� m �h2�>�My Commission Expires- �al.arr~� ENTI <br /> NOTARY PUBLIC <br /> j STATE OF COLORADO <br /> NOTARY FOR STRUCTURE OWNER NOTARY ID 20144043949 <br /> lly COMMISSION EXPIRES NOVEMBER 13,2022 <br /> ACKNOWLEDGED BY: <br /> Structure Owner(s): Housing Authority <br /> of Pueblo Contact name(print): <br /> Signature: Date: O <br /> Title: U G <br /> STATE OF <br /> ) SS <br /> COUNTY OF o ) <br /> The` foregoing was acknowledged before me this __'�1 day of c , 20,-!,, by <br /> Notary Public My Commission Expires: <br /> CHERYL L. WILKERSON <br /> NOTARY PUBLIC <br /> STATE OF CAIARADO <br /> NCTARY ID# 19964004153 <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL 4 70181130000165522657 MY COMMISSION EXPIRES 03/08/2024 <br />