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REC� <br /> OOq <br /> U6 - 00 <br /> An example Structure Agreement which meets the requirements of the Statutes is shown bellow. 4a0360V" <br /> �;d►n9 <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 beaveen 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 negative effect"on their utility.(Construction Materials Rule 6.3.12 and Rule 6.4,0&Hard <br /> Rock/Metal Mining Rule 6.3.12 and Rule 6.4.20) <br /> The Colorado Mined Land Reclamation Board("Board')has determined that thisform, if <br /> properly executed, represents an agreement that complies with Construction Materials Rule 6.3.12(a), <br /> Rule 6.419(a), and C.R.S. §34-32.5-115(4)(c)and with Hard Rock/Melal Mining Rule 6.3.12(a),Rule <br /> 6.4.20(a), and C.R.S. §34-32-115(4)(d). Thisform is for the sole purpose of ensuring compliance with the <br /> Rules and Regulations and shall not make the Board or Divjsion a necessary party to any private civil <br /> Irnvsuit 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 /> )d jZ_KKZh "o Y�.00s <br /> 2. t?hS �` - l2 .. J� 1� i) e -n1 <br /> 3. <br /> Received Time Jul. 6. —2016-10;47AN-No. 0096 <br />