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-�- <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 /> appiicanboperator (Secrion 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 operarion will be located on lands where such operations are prohibited by law(Secrion34-32-115(4)(fl, <br /> C.R.S. 1984,as amended); <br /> 5. As the applicant/operator, I do not have any minuig/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 appiication 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 1484,as amended. <br /> This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-IIO,C.RS., of the Mined Land <br /> Reclamation Acx Any alteration or modification of this form shall resutt 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 <br /> Signed an1dated t 's j "I day of f' �� �ZZ_ <br /> i <br /> % <br /> If Corporation Attest(Seal) <br /> A andOp tor <br /> By: By. <br /> Corporate Secretary or Equivalent <br /> Title: Town/City/County Clerk <br /> SOPHIA L.WALLS <br /> State of_ � l(�IrCl..�l U ) STATE OF COLOLRADO <br /> �o�d-�r �SS' NOTARY ID 20114016824 <br /> County of � MY COMMISSION EXPIRES 03I18I2023 <br /> The foregoing instrument was aclaiowledged before me this ��� day of Q��"1 � , ���- , <br /> by �0�1v� .1,COt�+�_ as�(��� of <br /> � � G� <br /> otary Pub ic <br /> My Commission expires: 3-a��,Z.f�7�.� <br /> SIGNATURES MUST BE IN BLUE INK <br />