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-7- <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. All necessary approvals from local government have been applied for(Rule 1.6.2(1)and(2)); <br /> 2. This entire mining operation will not extract more than 70,000 tons of mineral, overburden, or combination thereof in <br /> any calendar year(defined in C.R.S.34-32-110(2)(a)); <br /> 3. This mining operation will not adversely affect the stability of any significant, valuable and permanent man-made <br /> structure(s) located within two hundred (200) feet of the affected lands. (However, where there is an agreement between the <br /> applicant/operator and the persons having an interest in the structure that damage to the structure is to be compensated for by the <br /> applicant/operator (Section 34-32-115(4)(d), C.R.S. 1984, as amended), then mining may occur within 200 feet. Proof of an <br /> agreement must be submitted to the Office prior to the decision date.) <br /> 4. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32-115(4)(f), <br /> C.R.S. 1984,as amended); <br /> 5. As the applicant/operator, I do not have any mining/prospecting operations in this state of Colorado currently in <br /> violation of the provisions of the Mined Land Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined <br /> through a Board finding. <br /> 6. I understand that statements in the application are being made under penalty of perjury and that false statements made <br /> herein are 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 34-32-110(1),C.R.S., of the Mined Land <br /> Reclamation Act Any alteration or modification of this form shall result in voiding any permit issued on the altered or modified <br /> form and subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section <br /> 34-32-123, C.R.S. <br /> I C) �' <br /> Signed and dated this day of GV� <br /> ePuit, If Corporation Attest(Seal) <br /> A lic rator <br /> PP P <br /> Sign By: JACO)! (. L2 l CO By: <br /> Corporate Secretary or Equivalent <br /> Title: Town/City/County Clerk <br /> State of P v i z)r J ) <br /> )ss. <br /> County of I'c5,i 1L ) <br /> The foregoing instrument was acknowledged before me this 1 8, day of 1.30 o,e wi bRr , 0011 , <br /> by Ackezi i, P 1.11,r;e as of . <br /> • <br /> . liA1 w\. G-- _ <br /> Notary Public <br /> My Commission expires: i 1 SJ 0.2 <br /> SIGNATURES MUST BE IN BLUE IAII( <br /> TRICHON M EISENMAN <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20074008696 <br /> MY COMMISSION EXPIRES FEBRUARY 05,2022 <br />