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Varna 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 provided 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 showing 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(112)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 /> the Operator,cons tt�envit establish ed�l <br /> 12022 <br /> Sign tur o{Adjacent Landowner A0 en'r Date <br /> Print Name <br /> SHARON BENSON <br /> State of L c I C /°L C ) NOTARY PUB <br /> STATE OF COL <br /> SS. MY CO�AAA1831ARY <br /> 0 EX MMAY 24.ZO�Z2 <br /> County of (.(,}2 I d ) <br /> The foregoing instrument was acknowledged before me this 5 day of fv(a✓I �2022, <br /> by L ' Jc`- r rl1e I)c-,a tcl c for ule/d i,114 <br /> [J+ .Jz;. -,71 l )- Title <br /> r n —I <br /> Company or Corporation <br /> Notary Public <br /> My Commission expires: <br /> 2 <br />