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Certification: <br /> As an authorized representative of the applicant. I hereby certify that the operation described has met the mininuun requirements of the <br /> following terms and conditions: <br /> 1. This mining operation will not advcrselyallect the stability of any significant,valuable and permanent man-made slruclure(s)located <br /> within two hundred(200)feet of the affected lands. (However,where there is an agreement between the applicant!operator and the <br /> persons having,an interest in the structure that damage to the structure is to be compensated for by the applicant operator(Section <br /> 834-32-1 15(4)(d),C.R.S. 1984,as amended),then mining may occur within 200 feet. Proofofan agreement mast be submittedto the <br /> Office prior to the decision dale.) <br /> 2. No mining operation will be located on lands where such operations are prohibited by law(Section 34-32-115(4)(t),C.R.S. 1994,as <br /> amended), <br /> 3. As the applicanuoperator, I do not have any mining/p ros peel ing 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 detemiined through a Board 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 1 misdemeanor pursuant to Swim 18-8-503,C.R.S. 1984,as amended. <br /> This fimrm 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 Auv alteration or modification of tins form shall result in voiding anj,permit issued on the altered or tuodifred fo me <br /> and subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section 3.1-32-123, <br /> C.R.S. <br /> Signed and dated this���day of llN oyemb er 2 a Z I <br /> Ouray Silver Mines, inc. If Corporation Attest(Corporate/County Seal) <br /> Applipant/ e ator; n�e <br /> Signature: Brian K. Briggs <br /> By: <br /> Brian <br /> Secretary or Equivalent <br /> Title: O Town/City/County Cleric <br /> State of ) <br /> County of <br /> The foregoing instrwnent was acknowledged before me this s day of l V CVe WOCr . 102 <br /> by as of <br /> r r <br /> Notary Public f �7 <br /> CHERYL MELINO My Commission expires: <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20184030332 8 <br /> MY COMMISSION EXPIRES 07/27/2022 <br />