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An example Structure Agreement which meets the requirements of the Statutes is shown below. <br />Structure Agr_ Bement <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 mint 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 tlx: 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 6.3.13 and Rule 6.4. 19 & Haul <br />RoclrlMeial minx Rule 6.3.12 and Rule 6.4 30) <br />The Colorado Mined land Reclamation Board ("Board') has determined that this form, if <br />pruJwrlY executed represenn an agreement that complies with Construction Materials Rrrle 6.3.12(a). <br />Rule 6419(a), and C.A& S 34- 315- 115(4)(e) and wish Hard RocklMetal.M Ining Rule 6.3.13(a). Rule <br />64..20(a), and C.A.S. § 34- 32- 115(4)(d). This form is for the sulr purpose of en371ring compliance HIth the <br />Rules and Regulations and shall not make the Board or Division a necessary party to arty private civil <br />n <br />lawsuit to enforce the ter gfthe agreement or create any enforcement obligations in the Board or the <br />Division. <br />1. <br />2. <br />3. <br />4. <br />5. <br />The following structures ate located on or within 200 feet of the proposed affected area: <br />(Please litt additional stnicturc s on a Vepamte page) <br />