2017-04-24_PERMIT FILE - P2017006 (2)

Home Browse Search

a y (FORM 2 -All information.for DRMS use and cnnfidenlial.filing) VIII. SIGNATIIIJE REQUIREMENT r.rrrwnwwr Z26oncd s on the tine provided: verify that the foregoing information is true and accurate and commit to the reclamation of the prospecting;site as required by the Colorado Mined Reclamation Act and the rules as specified in the Hard Rock/Metal Mining Rules and Regulations and this NOI form. I have enclosed the required permit fee. I authorize the Division to contact and copy the BLM and/or USFS on any correspondence related to the prospecting operation,if the prospecting operation is located on federal public land. I have al,;o enclosed the appropriate reclamation surety amount or will post an amount as detennincd by the office, based on e projected costs of reclamation. the a p J I understand that I am not authorized to create any surface disturbance until the surety amount is posted and approved in writing from the Division of Reclamation,Mining and Safety. I accept and agree to comply with the foregoing terns and conditions and with all of the provisions of Rules 3 and 5, and C.R.S.34-32-101. I herby certify that concurrent with submittal of this NOl to the Division, I have sent notice to the Boards of County Commissioners in the Counties where the proposed activities will occur. This notice also indicated that non- confidential information regarding the proposed activities will be available for review at the Division's websitc. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-113, C.R.S., of the Mined Land Reclamation Act. Any alteration or modification of this fibrin shall result in voiding any NOI issued on the altered or rnarlified form and subject the operator to cease and desist orders and civil penalties for operating without a N01 pursuant to section 34- 32,123,C.R.S. 1,the undersigned beina the NO[ holder or the person authorized to sin on behalf of the NOI holder,declare that the infonnatron given io tg thig NOT fob is true and corrNt. SIGNATURES MUST BE IN BLUE INK Signed and dated this /�Idday of y' Signature of NOl h cr or person authorize sign: Name(,typedor print)rjnt) / &o Title/Position: fE