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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 of M-2001-001: <br /> All overhead and underground power lines,and accessories(e.g.guvlines,poles,signs)located on or near the right-of- <br /> way of State Highway 145,located between approximately MM 19.00R and 19.60R. <br /> CERTIFICATION <br /> The Applicant,SMITH'S MATERIALS LLC,by Broc Smith,as Manager,does hereby certify that Empire Electric Association, <br /> a Colorado cooperative(EEA)(structure owner)shall be compensated for any damage from the proposed mining <br /> operation to the above listed structure(s)located on or within 200 feet of the proposed affected area described above, <br /> of the Reclamation Permit Application for the Line Camp Pit(operation name)located on Line Camp(Ranch),File <br /> Number M-2001-001.The Applicant will comply with all applicable Federal/State Statutes and regulations. <br /> NOTARY FOR PERMIT APPLICANT <br /> ACKNOWLEGED BY: <br /> Applicant Smith's Materials LLC Representative Name Broc C Smith <br /> Date I .21.-t..2O22 - Title Manager <br /> STATE OF COLORADO <br /> ss. <br /> COUNTY OF MONTEZUMA ) �j� <br /> The foregoing was acknowledged before me this Z`T"'day of October,2022,by Broc C Smith as Manager of Smith's <br /> Materials LLC. <br /> My k-D010, ► My Commission Expires: Ut� icg-ir bg (seal) <br /> Notary Public <br /> NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEGED BY: <br /> Structure Owner Empire Electric Association Name <br /> Date /Q-e,.4- aO 3... Title ;,t <br /> STATE OF COLORADO <br /> ,n )ss. <br /> COUNTYOFIvtinS 'i t. <br /> T fore oin was_acknowledgectbefore <br /> me/this2L t y of a t/1 2022,by <br /> s� I <br /> C. 511'11 h as U W n'of )'n S Mate/1045 <br /> _ 0(10,4t\ 011CLk1 My Commission Expires: (19.-laX95 (seal) <br /> Notary Public <br /> Tara TARY PUBLIICa1d <br /> State of Colorado <br /> Notarryy ID#20214005788 <br /> Corrssbn 02112!2025 <br />