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2022-06-13_PERMIT FILE - M2022013 (3)
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2022-06-13_PERMIT FILE - M2022013 (3)
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Last modified
6/13/2022 2:49:02 PM
Creation date
6/13/2022 1:15:16 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2022013
IBM Index Class Name
Permit File
Doc Date
6/13/2022
Doc Name Note
Proof of Notification
Doc Name
Addendum To Application
From
Raptor Materials, LLC/Varra Companies
To
DRMS
Email Name
RDZ
MAC
Media Type
D
Archive
No
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Varra Companies, Inc. #� ' <br /> Office of Special Projects <br /> 8120 Gage Street Frederick Colorado 80516 Telephone(303)666-6657 Fax(303)666-6743 <br /> Statement of Understanding <br /> Landowner of Adjacent Structure Statement: Our notarized signature below testifies <br /> we have been proN ided with and opportunity to review: <br /> 1) a Stability Analysis Report pertaining to the proposed Two Rivers Sand Gravel and Reservoir <br /> Project-Regular Impact(112)Permit Application M-2022-013.:and, <br /> 2) a Map shoving the approximate relationship of our property and the potential for any <br /> qualified significant, valuable and permanent man-made structure(s), which may occur <br /> within 200 feet of lands affected within the proposed Two Rivers Sand.Gravel and Reservoir Project- <br /> Regular Impact(112)Permit Application M-2022-013. <br /> Upon review of the available materials reference here or the attending Public Notice; <br /> And,understanding the relationship of any significant, valuable and permanent man-made structures <br /> under our ownership and which may stand within 200 feet of lands affected within the proposed Two Rivers <br /> Sand,Gravel and Reservoir Project-Regular Impact(1_12)Permit Application M-2022-013., <br /> Further, by our signatures, as notarized below, we concur that planned activities detailed in the <br /> application for permit M-2022-013.; do not impact our qualified significant, valuable and permanent <br /> adjacent man-made structures, and to assure you that in the unlikely event damage occurs to such <br /> structures as a direct result of authorized active operations,those damages will be compensated for by <br /> :Z= <br /> d law. <br /> .f/Ja., .1. ,2022 <br /> Signature of A jacent Landowner Date - <br /> Print Name <br /> State of <br /> ! )ss. <br /> County of W C� ) <br /> The foregoing instrument was acknowledged beforc me this day of y)C -)021, <br /> by �_,2 Lu t 4Aa_TI c,G V for wC C <br /> ). Tide <br /> Company or Corporation ) <br /> Notary Public <br /> - LORRI AM CARLSON <br /> t4OTARY PUBLIC My Commission expires: 3 -a- <br /> STATE OF COLORADO <br /> NOTARY ID <br /> M 2 <br /> Y commtw oN EXPIRES MARCH 02,2025 <br />
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