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296363 97/24/2020 12:40 PM B 986 a 866 PERMIT <br /> Page 7 of 46 R S238.60 0 =0.00 ' $238.00 Clear CreeK <br /> 'III M MhylllNAK IW1, 411i III I <br /> Certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation dew--nbcd has met the nuntmum roquirements of the <br /> following terms and conditions; <br /> I All necessary approvals from local government have been applied for(Rule 1.6.2(i)and(2)); <br /> This entire mining operation will not extract more than ?0,000 tons of mineral,overburden. or combination thereof in <br /> an, calendar year(defined in C.RS.34-32-I10(2)(a)). <br /> 3. This mining operation will not ad%erwly affect the stability of any signifwaM, valuable and permanent man-made <br /> structurt(s) located within two hundred (200) feet of the affected lands (However, wren there is an agreement between the <br /> applicant`operator and the persaru having an interest in the structure that damage to the structure is to be compensated for by the <br /> applicanVoperator (Section 34-32-113(4X"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(4X0, <br /> C R S 1994,as amended t; <br /> As the applicant,operator. I do not have any mining prospecting operanons in this state of Colorado current:} in <br /> ti.olation of the provisions of the Mined Land Reclamation Act (Section 34-32-120.C.R.S. 1984. as amended) a&s determined <br /> through a Board finding. <br /> 1 1 understand that statements in the application are being made under penalty of penury and:hat false statements made <br /> herem arc punishable as a Class 1 misdemeanor pursuant to Section 18-8-503,C.R.S 1994.as amcrk!cd <br /> This form has been approved by the.Wined land Reclamation hoard pursuant to section 34-32-110(1).GR..K, of the.Wined Lard <br /> Reclamation Oct .4n►'alteration or modification of this form ihall result in voiding any permit issued on the altered or modified <br /> form and subject the operator to erase and desist orders and civil penalties for operating **hour a permit pursuant to section <br /> 34-32-123,C.R.S A <br /> Signed and dated this day of Jy� <br /> Salisbury Glad3t one LLC If Corporation Attest(Seat) <br /> ApplicanVOpentor c <br /> Signed By: _ By: <br /> Corporate Secretary or Fqui%alent <br /> Title: r _. ._ Town City'County Clerk <br /> State of <br /> ss. <br /> County of Q{ a4_ 1 <br /> The foregoing instrument was acknowledged before me this >j day of July 2020 <br /> by Jeff A Carter as Manager of Salisbury Gladstone LLC <br /> ou, <br /> COWS S WAS � Public <br /> Nowt,oter+e-�of Coww My Commission expstrs: O <br /> Notary 0 201 S10.W <br /> My Corrnaaron Eiip•as Oa'7 2021 <br /> SIGNATURES MUST BE IN BLUE INK <br />