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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,C.R.S., of the Mined Land <br />Reclamation Act Any alteration or modification of this form shall result in voiding anypermit issued on the altered or modified form <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 this day of <br />Newmont Goldcorp If Comoration Attest (Comorate/County Sea]) <br />Applicant/Operator Name <br />Signature: <br />Title: General Manager <br />State of C a l araz � ) <br />) ss. <br />County of <br />By: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this y 7!1, day of O g e__ , "ZD /I <br />m;Ae. SGts F,c'n w - <br />by as 6 /ri of _ 04? w1" N f �Ob�a�Ca l'P <br />I�X/ �&I <br />Notary Public <br />FNOIRMA M. TOMLEY <br />TARY PUBLIC <br />E OF COLORADO <br />Y ID 19834018402 <br />EXPIfiES DECEtr1BER:21201 <br />My Commission expires: i Z - Z / _.?i <br />