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Structure A reement <br />This letter has been provided to y ou 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 eaaluation 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 ctTect" on their utility. ( Construction ;lfaierials Rule 6 3.1? and Rule 64.19 d Hard <br />RoclvHetal ?Mining Rule 6.332 and Ride 64.20) <br />The Colorado dined Lund Reclamation Board ( "Board ') has determined that this form, if <br />properly executed, represents an agreement that complies with Construction Afaterialr Rule 6.,3.12(a), <br />Rule 6.4.19(x), and C.R.S. § 34-32.5-115(4)(e) and it,ith Hard Roeklhleral .Yining Rule 6.3,12(a), Rule <br />6.4.20(a), and C.R.S. S 34-32-11.i(4)(d). This form is fur the sola purpose of ensuring compliance with the <br />Rules and Regulations crud shall not make the Board or Division a necessary part3, to any private drill <br />lawsuir to enforce the terms ofthe agreement or create ant enfnrcemem 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 />I . <br />Greeley Water Line -City of Greeley 1100 10th St. Suite 300 Greeley, CO 80631 <br />Sinclair Pipeline - PO Box 185 Sinclair, WY 82334 <br />Lake Canal Ditch - Lake Canal Reservoir Company 13329 Weld CR 74 Eaton, <br />3. CQ <br />4. <br />5. <br />(Please list additional structures on a separate page) <br />