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Landowner of Adjacent Structure Statement: Our notarized signature below testifies we <br />have been provided with an opportunity to review a Map showing the approximate relationship of our <br />property and the potential for any qualified significant, valuable and permanent man -made structure(s), <br />which may occur within 200 feet of lands affected within the proposed Varra Resources Project 110 (OMLR <br />Permit it: M -1 984 -036 formerly Dakolios Pit). <br />Upon review of the available materials, including the written portion of Exhibit D — Extraction Plan from <br />the Amendment application; <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 Varra <br />Resources Project 110 (OMLR .Permit It: M 1984 - 036 formerly Dakolios Pit); <br />Further, by our signatures, as notarized below, we concur that planned activities detailed in the <br />application for permit M -1984 -036; do not impact 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 />' f/ � __ .4..0 /7 ,201 <br />Sign litre of Adjacent Lancowner Date <br />Print Name <br />8120 Gage Street Frederick, Colorado 80516 Telephone (303) 666 -6657 Fax (303) 666 -6743 <br />, State of ( l," cj <yV <br />County of <br />The foregoin T instrument was acknowledged before me this _y day of <br />20tpt, by L101eS �I���.F�C.t�� ( r��,c� n ►� For <br />). Title <br />Company or Corporation <br />Varra Companies, Inc. <br />Office of Special Projects <br />Statement of Understanding <br />) ss. <br />Notar Public <br />My Commission expires: <br />. jilt /il <br />2 <br />