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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 nine site.The State of Colorado.Division of Reclamation.Muting and Safety <br />- ("Division")roguitec-thst w1kcre-a""�operation will a&-crsely 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 Persons)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 owncr(s)of the utility that the mining and reclamation activities.as proposed,va7ll have <br /> "no negative effect"on their utility.(Construction Materials Rule 6.3.12 and Rule 6.4.19&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 this form, if <br /> properly executed,represents an agreement that complies with Construction Materials Rule 6.3.12(a), <br /> Rule 6.4.19(a), and C.R.S. §34-32.5-115(4)(e)and with Hard Rock/Metal Mining Rule 6.3.12(a),Rule <br /> 6.4.20(a),and C.R.S.§34-32-115(4)(d). This form is for the sole purpose of ensuring compliance with the <br /> Rules and Regulations and shall not make the Board or Division a necessary party to any 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. Perimeter Fence <br /> 2. Buildings <br /> 3. Water Well-Permit No.268245 <br /> 4. <br /> 5. <br /> (Please list additional structures on a separate page) <br />