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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 /> ifproperly executed, represents an agreement that complies with Construction Materials Rule <br /> 6.3.12(a), Rule 6.4.19(a), and C.R.S. §34-32.5-11 S(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-I15(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. Excel Energy - Overhead Electric Line and Pole <br /> 2. Service Postal <br /> 3. CERTIFIED o RECEIPT <br /> 4. ra Domestic Mail Only <br /> 5. C3 <br /> ra <br /> 3.11.15(Please list additional structures on a separate <br /> Certified Mail Fee <br /> Il'1 �,.-r <br /> $ II 1 ,C !OA cc <br /> f1 I Extra Services R Fees(cheek bwc add tee <br /> ❑Retum Receipt(hardcopy) $ '� <br /> rq ❑Return Receipt(electronic) $ PD <br /> 0 ❑Certified Mail Restricted Delivery $ IA I � <br /> Q ❑ t' <br /> AduR Signature Required $ r -ll t <br /> ❑Adult Signature Restricted Delivery$ <br /> C3 Postage I cc Ja� <br /> m $ R 19 <br /> Total Postage and <br /> ra ��I_i. <br /> $ <br /> co Sent T <br /> ra UGC/__ <br /> pt No.; ------------- ---- --- <br /> ---------------------- <br /> M1 • �^ <br />