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RECEIVED <br /> JAN 0 8 2026 <br /> DIVISION OF RECLAMATION <br /> MINING AND SAFETY <br /> An example Stnictiire Agreement which meets the requirements of the Statutes is shown below. <br /> Structure Agreement <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 located within 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 Applicant may supply a notarized letter, on utility letterhead, <br /> from the owner(s)of the utility that the mining and reclamation activities,as proposed,will have <br /> no negative effect"on their utility. ( Construction Materials Rule 6.3,12 and Rule 6.4.19& Hard <br /> i <br /> Rock/Metal Mining Ride 6.3.12 and Rule 6.4.20) <br /> : I <br /> i <br /> The Colorado Mined Land Reclamation Board("Board') has determined that this,fornt, if <br /> properly executed, represents an agreement that complies with Construction Materials Rule 6.3.12(a), <br /> Rule 6.4.19(a), and C.R.S. §34-32.5-115(4)(e)and with Hard Rock/Melal Mining Rule 6.3.12(a), Rule <br /> 6.4.20(a), and C.R.S. §34-32-I15(4)(d). This firm is for llte sole ptapose of ensttri►tg compliance►►fitly the <br /> Rules and Regulations and shall not make the Board or Division a necessary party to any private civil <br /> las►sttit to en1oree the terms of the agreement or create any en%ot cernew obligations in the Board or the <br /> Division. <br /> The following structures are located on or within 200 feet of the proposed affected area: <br /> i <br /> i. Barb wired fence twelve feet from the southern bou of said ng,P_d Gravel pit <br /> 2. <br /> 3. <br /> a. <br /> 5. <br /> (Please list addlfional structures on a separate page) <br /> i <br /> I <br />