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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 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 Heintzelman Project (OMLR Permit <br />#: M- 2009 -018) and is located at or near the E /2,E/2, Section 31; and SW /4,SW /4, Section 28; all in Township <br />3 North, Range 67 West; 6 P.M.; Weld County, Colorado. <br />Upon review of the available materials, including the the Amendment Map showing the planned Conveyor <br />Route within 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 <br />Heintzelman Project (OMLR Permit #: 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 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 />ma. (P 0.A) <br />atureof Adjacent Landowner <br />40€ t'.(- 'in(t4e r^ Ce -74- <br />Print Name <br />9-z <br />Date <br />State of On )6 WO ) <br />) ss. <br />County of (u--d G( ) <br />The foregoing nstrumas cknowledged before me this tick day of <br />20200, by �e w <br />) t — Keliiiit0 CiCJ &Z _' ( P.O. . <br />S.Se., Cam, b !e !m ). Title <br />Companti or Corporation <br />o 'ublic - <br />tary <br />for <br />,2011 <br />My Commission expires: <br />i <br />2 <br />