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An example Structure Agreement which meets the requirements of the Statutes is shoran below. <br />* sssssssss ss s** srs* ssssssss**** s** sssss sss s*** t* sass s* ss * * * * * * * * *ss *s + * * * * * * *ssssssss <br />Structure Agreement <br />This letter has been provided to you as the owner ol'a structure on or within two hundred (200) <br />feet of a proposed mine site. The State of Colorado, Division of Acclamation, Mining and Safer}, <br />(`Division") requires that where a mining operation will adversely atTi ct the stability of any significant, <br />valuable and permanent man-made structure located within two hundred (200) fret of the affected land, <br />the Applicant shall either. <br />a) Provide a notari2ed agreement between the Applicant and the Percon(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 demom-oratcs 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 notarised letter, on utility letterhead, <br />from tlx; owners) of the utility that the mining and reclamation activities, as proposed, will have <br />"no negative effect" on their utility. ( Constnw ion :Valerialr Rule 6.3.12 and Rule 6.4.19 er Hard <br />R(mV.Veial lllining Rule 6.3.12 and Rule 6.4 30) <br />77te Colorado :Wihed Lord Reclamation Board ( "Board ") hue determined that this form, if <br />properly esecuteslt represents an agreement that compliers with Construction .YateriaLc Rule 6.3.12(a), <br />Rule 6.419(a), and C R.& S 34. 32.5- 115(4)(e) and with Hard Rock/Metal.wining Rule 6.3.12(a), Ride <br />6.4 20(a), and C. PUT. § 34- 32- 115(4) (d). nis 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 arm private civil <br />lawsuit to enforce the terms of the. agreement or emate any enforcement obligations in the Board or the <br />Division. <br />2. <br />3. <br />4. <br />S. <br />The following structures are located on or within 200 feet of the proposed affected area: <br />(Please list additional slruclures on a separate Page) <br />