2024-11-27_REVISION - M2016081 (5)

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-8- Certification: As an authorized representative of the applicant,I hereby certify that the operation described has met the minimum requirements of the following terms and conditions: 1. This mining operation will not adversely affect the stability of any significant,valuable and permanent man-made structure(s)located within two hundred(200)feet of the affected lands. (However,where there is an agreement between the applicant/operator and the persons having an interest in the structure that damage to the structure is to be compensated for by the applicant/operator(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 the Office prior to the decision date.) 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. 1984,as amended); 3. As the applicant/operator, I do not have any mining/prospecting operations in this state of Colorado currently in violation of the provisions of the Mined Land Reclamation Act(Section 34-32-120,C.R.S.1984,as amended)as determined through a Board finding. 4. I understand that statements in the application are being made under penalty of perjury and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503,C.R.S 1984,as amended. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-112,CR.S.,of the Mined Land Reclamation Act Any alteration or modification of this form shall result in voiding any permit issued on the altered or modified form and 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 day of I n r V d V e b-cr 2 0 2_ 14-* AuPt Industries If Corporation Attest(Seal) A icant/O erator or Company Name Si • Signed: Corporate Secretary or Equivalent Town/City/County Clerk Title: No TAR'/ 't uBLSC State of Cb LC)2A7tc ) ss. County of i4 n-1 L_E The foregoing instrument was acknowledged before me th•is 22+` day of OV M 13E , 2o by -PETER_ NGMSER- EE1 MAN as OW IN E 2, / of AAA-Pf INDIAS KAYLEE DENYSE BOSSE NOTARY PUBLIC Notary Public STATE OF COLORADO NOTARY ID 20244014275 My Commission expires: MY COMMISSION EXPIRES 04/11/2028 SIGNATURES MUST BE IN BLUE INK