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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)feet of a <br /> proposed mine site. The State of Colorado, Division of Reclamation, Mining and Safety ("Division") <br /> requires the where a mining operation will adversely affect the stability of any significant,valuable and <br /> permanent man-made structure located within two hundred(200)feet of the affected land,the Applicant <br /> 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 properly <br /> executed, represents an agreement that complies with Construction Materials Rule 6.3.12(a), Rule <br /> 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 6.4.20(a), <br /> and C.R.S. §34-32-115(4)(d). This form is for the sole purpose of ensuring compliance with the Rules and <br /> Regulations and shall not make the Board or Division a necessary party to any private civil lawsuit to <br /> enforce the terms of the agreement or create any 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 /> Water Well <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> S. <br /> (Please list additional structures on a separate page) <br />