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RE 7! E <br /> JUL -i 3 202z <br /> rWISION OF RECLAMATION. <br /> IV..;J1NG&SAFETY-MINER, <br /> Structure Aereement <br /> This letter has been provided to you as the owner of a structure on or within two hundred(200)feet <br /> 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 the <br /> affected land,the Applicant shall either. <br /> a) Provide a notarized agreement between the Applicant and the Person(s)having an interest in <br /> the structure,that the Applicant is to provide compensation for any damage to the structure; <br /> 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 <br /> activities occurring at the mining operation;or <br /> e) Where such structure is a utility,the Applicant may supply a notarized letter,on utility <br /> letterhead,from the owner(s)of the utility that the mining and reclamation activities,as <br /> proposed,will have"no negative effect"on their utility.(Construction Materials Rule 6.3.12 <br /> and Rule 6.4.19&Hand Rock/Metal Mining Rule 6.3.12 and Rule 6.4,20) <br /> The Colorado Mnred Land Reclamation Board("Board')has determined that this form, ttfproperly <br /> executed, represents an agreement that complies Evith Construction Materials Rule 63.12(a).Rule <br /> 6 419(a).and C.R.£§34-32.5-115(4)(e)and+vith HwW RocldMetal Mining Rule 6.3.12(a), Rule <br /> 6.4 20(a), and C.R.S.§34-32-113(4)(d). Thisform is for the sole purpose of ensuring compliance <br /> with the Rules and Regulations and shall not make the Board or Division a necessary party to any <br /> private civil lawsuit to enforce the terns of the agreement or create any enforcement obligations in <br /> the Board or the Division. <br /> The following structures are located on or within 200 feet of the proposed disturbed area: <br /> L Utility Easement(water pipelines and appurtenances)recorded at 3535556 on 02/14/2008 <br /> in Weld County,CO <br /> 2. <br /> I <br /> 4. <br /> + (Please list additional structures on a separate page) <br />