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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 following <br /> 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 any <br /> calendar year(defined in Rule 1.1(24)); <br /> 3. 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 and <br /> the persons having an interest in the structure that damage to the structure is to be compensated for by the applicant/operator <br /> (Section 34-32-115(4)(d),C.R.S.1984,as amended),then mining may occur within 200 feet. Proof of an agreement must be submitted to <br /> 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),C.R.S. <br /> 1984,as amended); <br /> 5. 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 finding. <br /> 6. 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 34-32-110,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 form and <br /> subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section 34-32-123,C.R.S.Signed and dated this y�� day of i4//'/i4//'/ r/ , O2 y . <br /> cri, /6;,/,- Z,2�d 6.2-1 If Corporation Attest(Seal) <br /> Applicant/Operator <br /> Sign ; 1 "fes <br /> tAPIP Signed: <br /> Corporate Secretary or Equivalent <br /> Title: / 4! Town/City/County Clerk <br /> rl <br /> State of (7 '0 t'61 ) <br /> 1n )ss. <br /> County of k v ` S a ) <br /> The foregoing instrument was acknowledged1 _ before me this day of C', ` 10 2.4-1by t,,i_ \-�D 'e("Cs l3`n as \r & C tom" ofTuD 5 L . Cv LLC, <br /> JACQUELINE L. RALEY NOTTfl PUBLIC <br /> NOTARY PUBLIC C� 5.— <br /> STATE OF COLORADO My Commission expires: L� <br /> NOTARY ID#19914013891 SIGNATURES MUST BE IN BLUE INK <br /> My Commission Expires August 10,2025 <br />