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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 an existing mine <br /> site.The State of Colorado,Division of Reclamation,Mining and Safety("Division")requires that where a mining <br /> operation will potentially adversely affect the stability of any significant,valuable and permanent man-made structure <br /> located within two hundred(200)feet of the affected land,the Applicant/Operator shall either: <br /> a)Provide a notarized agreement between the Applicant/Operator and the Person(s)having an interest in the structure, <br /> that the Applicant/Operator is to provide compensation for any damage to the structure;or <br /> b)Where such an agreement cannot be reached,the Applicant/Operator shall provide an appropriate engineering <br /> evaluation demonstrating 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 Mined Land Reclamation Board("Board")has determined that this form,if properly executed,represents an agreement <br /> that complies with Construction Materials Rule 6.3.12(a),Rule 6.4.19(a),and C.R.S.§34-32.5-115(4)(e)and with Hard Rock/Metal <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 /> State Highway 145,a paved 2-lane(with shoulders and auxiliary lane/access road owned,managed and maintained by <br /> CDOT,including culverts,signs and other associated structures,located between approximately MM 19.00R and 19.60R, <br /> and All other structures owned and maintained by the CDOT. <br /> CERTIFICATION <br /> The Applicant,SMITH'S MATERIALS LLC,by Broc Smith,as Manager,does hereby certify that the Colorado Department <br /> of Transportation(CDOT)(structure owner)shall be compensated for any damage from the proposed mining operation <br /> to the above listed structure(s)located on or within 200 feet of the proposed affected area described above,of the <br /> Reclamation Permit Application for the Line Camp Pit(operation name)located on Line Camp(Ranch),File Number M- <br /> 2001-001.The Applicant will comply with all applicable Federal/State Statutes and regulations. <br /> NOTARY FOR PERMIT APPUCANT <br /> ACKNOWLEGED BY: <br /> Applicant Smith's Materials LLC Representative Name Broc C Smith <br /> Date /d-14 Title Manager <br /> STATE OF COLORADO <br /> ss. <br /> COUNTY OF MONTEZUMA <br /> The foregoing was acknowledged before me this 16031 day of October.2022,by Broc C Smith as Manager of Smith's <br /> Materials LLC. <br /> . tR0(-0 f1itL beI .001My Commission Expires: (2l1ala6:7 " <br /> Notary Public <br /> NOTARY FOR STRUCTURE OWNE <br /> ACKNOWLEGED BY: <br /> Structure Owner Colorado Department of Transportation Name <br /> Date I0'/'1 d 1. Title4Plrir1 t/.` <br /> STATE OF COLORADO ) �} <br /> Nq�yT tl �)ss. <br /> COU NTY OFI�r�«-'�'""'T �}�,,� <br /> Tt�e�regoir�g w ac` pwledaged�before methislgday�of <br /> of 15 <br /> 22, by �S <br /> w Lr h i1t MO ML eY12 <br /> Jalook mems i.k i My Commission Expires: oat wows <br /> Notary Public <br /> Tara Jo McDonald <br /> NOTARY PUBLIC <br /> State ofColorado <br /> !21_� 57 <br /> W/12/2025 <br />