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8 - <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />1. This mining operation will not adversely affect the stability of any significant, valuable and permanent man-made structure(s) <br />located within two hundred (200) feet of the affected lands. (However, where there is an agreement between the applicant/operator <br />and the persons having an interest in the structure that damage to the structure is to be compensated for by the applicant/operator <br />Section 834-32-115(4)(d), C.R.S. 1984, as amended), then mining may occur within 200 feet. Proof of an agreement must be <br />submitted to the Office prior to the decision date.) <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32-115(4)(f), C.R.S. <br />1984, as amended); <br />3. As the applicant/operator, I do not have any mining/prospecting operations in this state of Colorado currently in violation of the <br />provisions of the Mined Land Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through a Board <br />finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements made herein are <br />punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984, as amended. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-112,0 R.S, of the Mined Land <br />Reclamation Act. Any alteration or modification of thisform shall result in voiding any permit issued on the altered or modifiedform <br />and subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section 34-32-123, <br />C.R.S. <br />Signed and dated t is 1 day of l.r004081,-- v6 <br />Cripple Cree : Victor Go : Mining Company <br />Appli •n Iperator 'flame <br />Signature: <br />Gen: al Mana <br />Title: <br />er <br />State of CO biCAd 0 <br />County of e Ref ) <br />ss. <br />The foregoing instrument was acknowledged before me this <br />by 11t,sN1 <br />If Corporation Attest (Corporate/County Seal) <br />By: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />day of car <br />pke(kki-VtelzxC did Mt v l4fl <br />ma,1/44‘k, a`1 <br />Not Pubblliicc <br />My Commission expires: t' c J <br />y..,,,. , ... <br />kr: $OTAfil, <br />to <br />41 <br />caPr9