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An example Structure Agreement which meets the requirements of the Statutes is shown below. <br />sas sass s****** sas*s ss* s** s* sss* s**+ t** b***** ssses+ r** a�►**+ � * *+x *sssss *ss *rrs�csss *ass*ss *# <br />Structure Aereement <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 areement bemeen 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 raining operation; or <br />c) Where such structure is a utility, the Applicant may supply a notmized 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. ( C'omstruction ,'Materials Rule 6.3.12 and Rules 64.19 &- Hard <br />Rock/Metal ?burring Rule 63.12 and Rule 6.4.20) <br />The Colorado ibrned Lwrd Reclamation Board ( "Board') has determined that this form, if <br />properly executed represents an agreement that complies with Construction .Materials Rule 63.12(a), <br />Rule 6.4.19(a). and C._R..S. § 34-3Z5-115(4) (e) and with Hard RocklUetal Mining Rule 6.3.12(x), Rule <br />64.20ta), and C. X& § 34- 32- 115(4)(4). This form 4v for the sole purpose of ensuring compliance With the <br />Rules and Regulations and shall not make the Board or Division a necussary party to any private civil <br />lawsuit to enforce the terms of the agreement or create any er foreement obligations in the Board or the <br />Division. <br />The following structures are located on or within 240 feet of the proposed affected area: <br />1. Sgm' (" a2 L E mgi z. <br />2. <br />3. <br />4. _. <br />5. <br />(Please list additional srructures on a separate page) <br />