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RECEIVED <br />F.it +k r -.•.. •f.m.f�F4i <br />Division of Reclamation, <br />Mining & Safety <br />Structure Agreement <br />This letter has been provided t0 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 nct'alive effect- on their utility. (Materhd.v Rick 6.3.12 and Rule 6.4.1 9 c[ flan! <br />Rock/Metal Mining Rule 6.3,12 ond Rule 6.4.20) <br />The C`rrlw-ado Alined Land Reclamation Board ("Board") has determined that this_for•m. if <br />properly executed represents an agreement that complies with Construction Materials Rule 6.3,12(a), <br />Rule 6.4.194/, and C.R.S. § 34.32.5-115(4)41 and with Hard Rock/Metal Mining Rule 6.3.12(a). Rule <br />15,4, 20(x1. and C.R.S. § .34-32-11) (-l) (d). This fOrin ie Jin- the sole purpose of ensuring compliance with the <br />Rules and Regulations caul shall not make the Board or Division a nec•essan' party to any private civil <br />Ienvsarit to enfhrce the terms of the agreement or ereetic rttr3' enfhrtcm etc obligations in the Board or 11w <br />3. <br />4. <br />5 <br />The following structures are located on or within 200 feet of the proposed affected area: <br />Rio Blanco County Road 27 <br />(Please list additional structures On a sepat cite page) <br />