2012-05-04_REVISION - M1999120

• Permit No: M1999120
• IBM Index Class Name: REVISION
• Doc Date: 5/4/2012
• Doc Name: COPIES: Proof of Publication, Adjoining Owner Return Receipt cards, 12 executed Structure Agreements
• From: ENVIROMENT, INC.
• To: DRMS
• Type & Sequence: AM2
• Email Name: ECS
• Media Type: D
• Archive: No

L.G. EVERIST, INC.
February 17, 2012
RECEIVED
3 2012
L G. EVERIST, INC.
RE: Damage Reimbursement Agreement
L.G. Everist, Inc. - Fort Lupton Sand and Gravel Mine Permit # M-1999-120
Harry & Martha Inouye
12210 WCR 14.5
Fort Lupton, CO 80621
Dear Mr. & Mrs. Inouye:
L.G. Everist, Inc., is making an amendment to their Colorado Mined Land Reclamation (MLR) permit to
extract construction materials from a tract of land located in Parts of Section 19, 30 & 31, T-2-N, R-66-W
and parts of Sections 25, & 36, T-2-N, R-67-W, 6th Prime Meridian, Weld County, Colorado.
State MLR law requires the permit applicant to agree to reimburse the owner of any permanent man-made
structure(s) within 200 feet of the mining area for damage done to the structure(s) as a result of the
permitted operation. We believe Harry & Martha Inouye own the structure(s) listed below. L.G. Everist,
Inc. agrees to reimburse Harry & Martha Inouye for any damage done to the structure(s) listed below as a
result of the proposed mining operation. Your acknowledging signature and a notary seal in the spaces
provided below should satisfy the MLR law reimbursement requirement.
Please return this agreement within 30 days of receiving it if at all possible. Enclosed is a stamped
addressed envelope so you can returned the executed agreement to us. We have also enclosed a
second copy of this letter that you may keep for your files. Thank you for your cooperation.
Sincerely,
Lynn Mayer Shults
Regulatory Manager
cc: Division of Reclamation, Mining & Safety
file
Structure list:
Block Barn, wood corals, 4 strand wire fence
L Dawn Koshio Gillespie
Notary Public
State of Colorado
1
My Commission Expires 9.21.2014
ACKNOWLEDGED BY:
Harry & Martha Inouye
STATE OF aol&W,I.Lic) )
) ss.
COUNTY OF \1\19A4 )
My commission expires:
CORPORATE OFFICE
300 S. PHILLIPS AVE • SUITE 200
PO. BOX 5829
SIOUX FALLS, SD 57117.5829
PHONE [phone]
FAX [phone]
MOUNTAIN DIVISION
7321 E. 88TH AVENUE • SUITE 200
HENDERSON, COLORADO 80640
303-287-9606
FAX [phone]
The forgoing was acknowledged, subscribed
and sworn to befoe me, a Notary Public
this 2.5* day of i-evrtAtt.v ,
By Nk ttA, AvAntA
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Notary Public
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