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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 proposed mine <br /> site.The State of Colorado, Division of Reclamation,Mining and Safety("Division")requires that where a mining <br /> operation will adversely affect the stability of any significant,valuable and permanent man-made structure located <br /> within two hundred(200)feet of the affected land,the Applicant shall either: <br /> a)Provide a nc tarized agreement between the Applicant and the Person(s)having an interest in the structure,that the <br /> 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 engineering evaluation that <br /> demonstrates that such structure shall not be 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 utility letterhead,from the owner(s) <br /> of the utility that the mining and reclamation activities,as proposed,will have"no negative effect"on their utility. <br /> (Construction Materials Rule 6.3.12 and Rule 6.4.19&Hard Rock/Metal Mining Rule 6.3.12 and Rule 6.4.20) <br /> The Colorado M;ned Land Reclamation Board("Board")has determined that this form,if properly executed,represents an agreement <br /> that complies Wth Construction Materials Rule 6.3.12(a),Rule 6.4.19(o),and C.R.S.§34-32.5-115(4)(e)and with Hard RocIVMetal <br /> Mining 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 ensuring compliance with the <br /> Rules and Regulations and shall not make the Board or Division a necessary party to any private civil lawsuit to enforce the terms of <br /> 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 /> l. Tavlor Lane,a gravel road (aka FS-635 <br /> CERTIFICATION <br /> The Applicant,CROSSFIRE AGGREGATE SERVICES LLC, by Perry Neil,as General Manager,does hereby certify that <br /> Hinsdale County(structure owner)shall be compensated for any damage from the proposed mining operation to the <br /> above listed structure(s)located on or within 200 feet of the proposed affected area described within Exhibit A,of the <br /> Reclamation Permit Application for the Toner Ranch Pit(operation name), File Number M-2021-011. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Crossfire Aggregate Services LLC Representative Name Perry Neil <br /> Date 3 1 '.I Title General manager <br /> STATE OF C LORADO ) <br /> )ss. <br /> COUNTY OF1,GtjY4& ) <br /> The foregoing was acknowledged before me this day of N1Ah&L­, ,2021,by Perry Neil as General Manager of <br /> Crossfire Aggregate Services LLC. <br /> Brook E. Lee <br /> NOTARY PUBLIC <br /> STATE My Commission Expires:2NOTARY Do 2ow4o= <br /> Notary Public tin'COMMISSION EXPIRES o2,14,2M <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEGED BY: <br /> Structure Owrer Hinsdale County Name Don Menzies <br /> Date .3 JAI 62e-74 I Title Road And Bridge Supervisor <br /> STATE OF COLORADO ) <br /> )ss. <br /> COUNTY OF ih`/Af Ph W p _/ <br /> The foregoing was acknowledged before me thise� day of 20*1 L by <br /> ne�u MMZIR as 6UP&—RV1S0R of NUUSOMA ROAD SRipGIE <br /> REBECCA BETHARD CAMPBELL <br /> My Commission Expires:��o�� NOMARYPUBW <br /> Notary Public STATE OF COLORADO <br /> NOTARY IDi 2OM4=13 <br /> MY COMMISSION EXPIRES O40=4 <br />