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THIS AGREEMENT is entered into this day (dated by Structure Owner) of <br />2011, by and between Oldcastle Southwest Grow, Inc. (hereinafter referred to as the "Applicant ") <br />whose address is c1p Paul Banks and Associates, LLB 720 Kipllnq Street te 117 <br />Lakewood, Colorado 80215 and Town of Debeque, (hereinafter referred to as the "Structure <br />Owner") whose address is 381 Minter Avenue, PO Box 60. Debeque, CO 61630. <br />The Applicant is seeking a State of Colorado Mined Land Reclamation Board Permit to mine sand <br />and gravel and to reclaim property as identified in the legal description (see Attachment A) and as <br />depicted on the enclosed Location Map (see Attachment B). <br />The Structure Owner owns a permanent man -made structure within 200 feet of the land affected <br />by mining and reclamation operations. This structure is an Underground Water Line. <br />Attachments A and B are attached hereto and are part of this Agreement. <br />The Applicant hereby commits to fully repair or to fully compensate the Structure Owner for any <br />damage to the structure described above caused by the Applicant's mining and reclamation <br />operations. <br />AGREED: <br />BY THE APPLICANT: <br />D 42'49f, f SWA0'.av f 71-2C. <br />By: ". 4 4 • <br />Title: (- <br />State of Colorado <br />ss <br />County of ---- - ' '9 ) <br />The foregoing instrument was acknowledged before me this <br />by ? y -S• S; ecraVl 014f Witness my hand and official seal. <br />My Commission expires: Dp /, � /06 0 yy � aze---107 <br />Notary Public <br />BY THE STRUCTURE OWNER: <br />By: e; <br />Title: j?? ,t',114 <br />State of Colorado <br />County of M t� <br />) ss <br />AGREEMENT <br />Date <br />/ / <br />The foregoing instrument was acknowledged before me -14", t e.betz- <br />by TRO "�o�" <br />f itness r nit and official seal. <br />.�.° My Commis's+' n pires: 7- 7- a <br />SHIRLEY J. " <br />4 CMOLS <br />Lr„ <br />Y� 1 2d± ( t--- otaiy Pubii <br />