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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 reining and reclamation activities, as proposed, will have <br />,.no negative effect'' on their util ity. ( Construction Materials Rule 6.3.12 and Rule h. 4.19 & Hard <br />RocM&fetaI Alining Rule 6.3.1' and Rule 6.=1.20) <br />The Colorado Mined Land Reclamation Board ("Board') has determined that this form, if <br />properly executed represents an agreement that dompiies with Construction Muterials Rule 6.3.12(a). <br />Rule 6.4.19(a), and C.RS_ f 31-32.5-115(4)(e) and with Hard Rock,4-Ietai Mining Rule 6.3.12(a), Rule <br />6.4.20(x). and C.R.S § 34-32-115(4)(d). This form is for the sale purpose of ensuring compliance with the <br />Rules and Regulations and shall not make the Board or Division a necessary party to an)" 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. _ 014.- <br />-- a , <br />4. <br />5. <br />(Please list additional structures a►r a separate page) <br />Z -d 2909-Zt79-OL6 07 061­1e14ox3 �oolsen1J dt C:t�O 9 L 9 L Inf <br />