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I <br /> I <br /> 0 ( Pill 13 / <br /> RECEIVED <br /> An example Structure Agreement which meets the uiremen JAN 3 12019 <br /> *********************************** ******************* the Statutes is shown below. <br /> 1�0R`REpg <br /> MIN HAND SAFETY <br /> Structure Agreement <br /> i <br /> This letter has been provided to you as the owner of a s (tructure 'n or within two hundred 20 <br /> feet of a proposed mine site.The State of Colorado,Division of Reel ation,Mining and Safety0) <br /> ("Division")requires that where a mining operation will adversely a t the stability of an si nifica <br /> valuable and permanent man-made structure located within two hund y nt, <br /> the Applicant shall either: (200)feet of the affected land, <br /> I <br /> a) Provide a notarized agreement between the Applicant and the i#ejrson(s)having an interest in the <br /> structure,that the Applicant is to provide compensation.for anyj damage to the structure;or <br /> b) Where such an agreement cannot be reached,the Applicant shag,provide an appropriate <br /> engineering evaluation that demonstrates that such structure sh4O not be damaged by activities <br /> occurring at the mining operation;or <br /> e) Where such structure is a utility,the Applicant may supply a notrized letter,on utility letterhead, <br /> from the owner(s)of the utility that the mining and reclamation i�ctivities,as proposed,will have <br /> "no negative effect"on their utility.(Construction Materials RgK a 6.3.12 and Rule 6 4.19&Hard <br /> Rock/Melal Mining Rude 6.3.12 and Rule 6.4.20) <br /> The Colorado Mined Land Reclamation Board(',Boa, <br /> zl')has dgtermined 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.RS. §34-32.S-11 S(4)(e)and with Hard RocldMe 'I 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 purpo of ensuring compliance with the <br /> Rules and Regulations and shall not make the Board or Division a nets i1ratyparty lawsuit to enforce the terms of the agreement or create any enforcemen obcivil <br /> Division. ligions� the Board <br /> or the <br /> 'i <br /> The following structures are located on or within 200 feet of t) a proposed affected area: <br /> 1. Any Power lines and Poles <br /> 2• --._-Another electrical stuctures above or below ground within 200 set <br /> 3. <br /> 4. <br /> _ (Please list additional structures on a sepi rrate page) "- <br />