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Page 1/3 <br /> Structure Aural-tient <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. 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 significant, <br /> valuable and permanent man-made structure locatedwithin two hundred(200) feet of the affected land. <br /> the Applicant shall either: <br /> a) 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 . pplicar.t may supply a notarized letter. on utility letterhead. <br /> from the owner(s)of the utility that the minim;and reclamation activities, as proposed, will have <br /> "no negative effect" on their utility. ( (',ntstricIioii Materials Rule 6.3,12 and Rule 6.4.1 e9& Hard <br /> Rock."afetal alining Rule 6.3.12 and Rule 6.-1.201 <br /> /1w ('olnraclo Mined Lane!Re'elamatic», Road/("Board') has determined that this fOrm. i/ <br /> properly executed, re/,resents an agreement that complies with ('Un Iruclion .%laterial., Rule 6.3.1 tai. <br /> Rule 6.4.1940. and('.R.S. §34-32.5-115(4)tcl and with Hard Rock/Metal Mining Rule 6.3.12(al, Rule <br /> 6.4.20(a), and( R..S•. §34-32-I 1 5(41(d). ilttsc jOrm is/or the sole purpose ofensuring evntplienrcc with the <br /> Rules and Regulations and shall not make the Hoard or 1)ivis•ion a uee s.rat t•parts•1a ant'private civil <br /> Iatrcuil to cu/ore e the terms of the agree/nen/or create any enforcement ohlit,'ations n, the Board or the <br /> l>it inion. <br /> The following structures are located on or within 200 feet of the proposed affected area: <br /> Buried stormsewer and non-potable water lines and associated infrastructure. <br /> 3. <br /> 4. <br /> 5. <br /> (Please 1k!additional c1ructnres on a.ce%,aralL'page) <br />