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xA.hi L <br />An example Structure Agreement which meets the requirements of the Statutes is shown below. <br />Structure Agreement <br />This letter has been provided to you as the owner of a structure on or within two hundred (200) <br />feet of a proposed mine site. The State of Colorado, Division of Reclamation, Mining and Safety <br />( "Division ") requires that where a mining operation will adversely affect the stability of any significant, <br />valuable and permanent man -made structure located within two hundred (200) feet of the affected land, <br />the Applicant shall either: <br />a) Provide a notarized agreement between the Applicant and the Person(s) having an interest in the <br />structure, that the Applicant is to provide compensation for any damage to the structure; or <br />b) Where such an agreement cannot be reached, the Applicant shall provide an appropriate <br />engineering evaluation that demonstrates that such structure shall not be damaged by activities <br />occurring at the mining operation; or <br />c) Where such structure is a utility, the Applicant may supply a notarized letter, on utility letterhead, <br />from the owner(s) of the utility that the mining and reclamation activities, as proposed, will have <br />"no negative effect" on their utility. ( Construction Materials Rule 63.12 and Rule 64.19 & Hard <br />Rock/Metal Mining Rule 6 3.12 and Rule 6 4.20) <br />The Colorado Mined Land Reclamation Board ( "Board') has determined that this form, if <br />properly executed, represents an agreement that complies with Construction Materials Rule 6.3.12(a), <br />Rule 6.4.19(a), and C.R.S. § 34- 32.5- 115(4) (e) and with Hard RocklMetal Mining Rule 6.3.12(a), Rule <br />6.4.20(a), and C.R.S. § 34- 32- 115(4)(d). This form is for the sole purpose of ensuring compliance with the <br />Rules and Regulations and shall not make the Board or Division a necessary party to any private civil <br />lawsuit to enforce the terms of the agreement or create any enforcement obligations in the Board or the <br />Division. <br />The following structures are located on or within 200 feet of the proposed affected area: <br />1. kxis wex &tce_ 4neS C:)1`� iI i Ike a.Mccfed areo- <br />2. <br />3. <br />4. <br />5. <br />(Please list additional structures on a separate page) <br />