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ftc `,, _ <br /> An example Structure Agreement which meets the requirements of the Statutes is s wn b; cc'� <br /> S**��*****zb <br /> S�FRF 3Z��9 <br /> Structure Agreement P 4441 <br /> This letter has been provided to you as the owner of a structure on or within two hundred <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 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 owner(s) of the utility that the mining and reclamation activities, as proposed, will 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 /> fA S,56L/ i l oN N'�, `f POLES <br /> 2. � _� �v -OP T 1_ eIQNc 60 I�lrrp >� Sal; <br /> 4. N, ILr <br /> s. <br /> (Please list additional structures on a.separate page) <br />