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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 <br /> significant, valuable and permanent man-made structure located within two hundred (200) feet of <br /> the affected land, the Applicant shall either: <br /> a) Provide a notarized agreement between the Applicant and the Person(s) having an <br /> interest in the structure, that the Applicant is to provide compensation for any damage <br /> to the structure; or <br /> b) Where such an agreement cannot be reached, the Applicant shall provide an <br /> appropriate engineering evaluation that demonstrates that such structure shall not be <br /> damaged by activities occurring at the mining operation; or <br /> c) Where such structure is a utility, the Applicant may supply a notarized letter, on <br /> utility letterhead, from the owner(s) of the utility that the mining and reclamation <br /> activities, as proposed, will have "no negative effect" on their utility. ( Construction <br /> Materials Rule 6.3.12 and Rule 6.4.19 &Hard Rock/Metal Mining Rule 6.3.12 and <br /> Rule 6.4.20) <br /> The Colorado Mined Land Reclamation Board("Board') has determined that this form, <br /> if properly executed, represents an agreement that complies with Construction Materials Rule <br /> 6.3.12(a), Rule 6.4.19(a), and C.R.S. §34-32.5-115(4)(e) and with Hard Rock/Metal Mining <br /> Rule 6.3.12(a), Rule 6.4.20(a), and C.R.S. §34-32-115(4)(d). This form is for the sole purpose of <br /> ensuring compliance with the Rules and Regulations and shall not make the Board or Division a <br /> necessary party to any private civil lawsuit to enforce the terms of the agreement or create any <br /> enforcement obligations in the Board or the Division. <br /> The following structures are located on or within 200 feet of the proposed affected area: <br /> 1.Mary Ann Sink Trust <br /> 2. <br /> 3. U.S. Postal Service TI <br /> CERTIFIED MAIL RECEIPT <br /> o <br /> 4. Ln 1 Domestic mail , <br /> niy <br /> 5. ru <br /> r� <br /> (Please list additional Iflu, . <br /> .: Ay <br /> Certified Mail Fee c - <br /> ul C7..dl v firl"t1 <br /> r- $ <br /> M Extra Services&Feeslcheckbox,add fee apan I� Z� cc <br /> ❑Return Receipt(hardcopy) <br /> $ 41 p <br /> r-1 ❑Return Receipt(electronic) $ Z <br /> 0 ❑Certified Mail Restricted Delivery $ (( SIC <br /> 0 ❑Adult Signature Required $ <br /> ❑Adult Signature Restricted Delivery$ <br /> O Postage j cc d�a <br /> m $ <br /> CO Total Postage and c 05/28/2019 <br /> rq $ <br /> co Sent <br /> --- <br /> r` �'-`-="t --------------- <br />