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An example Structure Agreement which meets the requirements of the Statutes is shown below. <br /> ssrsrssssssssssrsssssssrsssssssssssssssssssrsssssrrssrrssrrsssssassssrssssrrrsrsssssr <br /> Structure 1(reement <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. 'Me 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 /> a1 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 /> RocklMetal 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 /> properh°executed, represents an agreement that complies with Construction Materials Rule 6.3.12(a), <br /> Rule 6.4.19(a), and C.R.S. §34-32.5-11 5(4)(e)and with Hard RocAJMetal Mining Rule 6.3.12(a), Rule <br /> 6.4.2O(a). and CR.S. §34-32-1/5(4)(d). This form is for the sole purpose of ensuring compliance xith the <br /> Rules and Regulations and shall not make the Board or Division a necessan•party to atn•private civil <br /> la►+suit 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 2W feet of the proposed affected area: <br /> Electricity distribution utility pole <br /> 1. <br /> 3. <br /> 4. <br /> S. <br /> (Please list additional structures on a separate page) <br />