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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 /> I. This mining operation will not adversely affect the stability of any significant,valuable and permanent man-made structures) <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 applicantloperator <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. 1 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 I 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,C.R.S., of the Mined Land <br /> Reclamation Act. Any alteration or modification of this farm shall result in voiding ant'permit issued on the altered or modified form <br /> and subject the operator to cease and desist orders and civilpenalties for operating without a permit pursuant to section 34-32-123, <br /> C R.S. <br /> Signed and dated this 0 Lh day of mG �C h '2o <br /> Sunrise Mining, LLC If Corporation Attest(Corporate/County Seal) <br /> Applicant/Operator Name <br /> Signature: By: <br /> Corporate Secretary or Equivalent <br /> Title: 0 n C,Je r Town/City/County Clerk <br /> State of Colorado ) <br /> ss. <br /> County of La Plata ) <br /> pi <br /> The foregoing instrument was acknowledged before me this ,ZO day of -Pylg�te./e, � 1 7 <br /> S,r,A ,G(in��S�S <br /> by as a r of nr '(3e 1,0i1n�, L—LC <br /> FAYE C.KOEHN <br /> NOTARY PUBLIC Notary Public <br /> STATE OF COLORADO <br /> NOTARY ID 19884004614 My Commission expires: I C - - a o /'C6 <br /> w cowmSWN EXPIRES OCTOIER 4 Z018 <br />