Laserfiche WebLink
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 we <br />have been provided with and opportunity to review: <br />1) a Stability Analysis Report pertaining to the proposed Heintzelman Permit Application M- <br />2009.018; 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 Heintzelman Permit Application M-2009- <br />018. <br />Upon review of the included materials; a copy of which will be included along with this Statement of <br />Understanding to the Colorado Division of Reclamation, Mining and Safety; <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 <br />Heintzelman Permit Application M-2009.018; <br />Further, by our signatures, as notarized below, we concur that planned activities detailed in the <br />application for permit M-2009-018 do not threaten our qualified significant, valuable and permanent <br />adjacent man-made structures; and that any damage to said structures directly attributed to the <br />activities of Varra Companies, Inc. (the Operator); will be compensated for by the Operator. <br />Q?65f -??'? , I Signature of Adjacent andowner <br />i ®i_ ?t?(12 <br />Print Name <br />State of (f?' d) u 0 r- t'?6 ) <br />ss. <br />County of <br />Z .2009 <br />Date <br />The forcgoin instrument was acknowledged before me this Z day of , <br />2009, by ( c J t for <br />Title <br />Company or Corporate ?Pr..•w?6'? <br />i KA <br />A <br />.? ? ?//y? <br />Notary Public <br />My Commission expires: 1-4-11) <br />2