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The notarized signatures of the Structure Owner Representative and the Applicant <br />Representative confirm the Agreement between the parties and the repair/compensation <br />obligation of the Applicant as stated above. <br />~~ IN WIT SS WHEREOF, the parties have executed this Agreement effective as of the <br />~"+ day of tQ..t,th) , 2004. <br />Agreed by the Applicant: L. G. EVERIST, INC. <br />-htp~es~~ n,ZOOs <br />Signature of R ive for L. G. Everist, Inc. Date <br />Name and Title (please print) <br />State of Colorado ) <br />)ss <br />County of ~~LII't`~ ) <br />'~te forego' instrument was acknowledged before me on this a`f day of <br />~~~~ 2004, by the signatory Representative above. Witness my hand and <br />official seal, <br />Notary <br />~ot~ar Pbe~~ . <br />blii: • ~ My Commission Expires. °~ • <br />Nom: 'O <br />grF~F.CQL~~~~ <br />FL-LBDCAgreement-Sep2004.DOC 70 <br />