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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 City of Pueblo- Board of Water Works own the following structure(s), located <br /> within 200 feet of the permitted mining area: Water and Sewer Mains <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 City of Pueblo-Board of Water Works shall be compensated for any damage from the <br /> proposed mining operation to the above listed structure(s) located within 200 feet of the permitted mining area <br /> described in the MLR 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 /> %t.ti ,C . <br /> Signature: ' Date: <br /> STATE OF Colorado ) <br /> ) SS <br /> COUNTY OF Pueblo ) . <br /> The foregoing was acknowledged before me this S day of 2020, by <br /> Matthew R.Welte as CEO of Summit Brick &Tile CO. <br /> Notary Public. My Commission Expires �i"— j,EEN L. i+G- <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY FOR STRUCTURE OWNER NOTARY ID 20144043945 <br /> MY COMMISSION EXPIRES NOVEMBER a 252'?I <br /> ACKNOWLEDGED BY: <br /> Structure Owner(s): City of Pueblo- Board of Water Works Contact name(print): <br /> Signature: — �l Date: o d1r %1z� ?0 <br /> Title: G 'rzt. 1� , f op r �,'o�r <br /> STATE OF C616%rkJ a ) <br /> COUNTYOF POA)o }ss <br /> The foregoing was acknowledged before me this day of U Y�,c. 20�a, by <br /> 4 <br /> i� <br /> Notary Public: My Commission Expires: <br /> KAA. ..44t- KRIISTEN A.GARNETT <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20074011346 <br /> SENT TO STRUCTURE OWNER VIA CERTIFIED MAIL # 70181130000165522817 MY COMMISSION EXPIRES MARCH 19,2023 <br />