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4 <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> described has met the minimum requirements of the following terms and conditions: <br /> 1 . All necessary approvals from local government have been applied for <br /> (Rule 3.20 )(d )); <br /> 2. This entire mining operation will not extract more than 70,000 tons of <br /> mineral , overburden, or combination thereof in any calendar year (Rule 3.2) ; <br /> 3. This mining operation will not adversely affect the stability of any <br /> significant, valuable and permanent man-made structure(s) located within <br /> two hundred (200) feet of the affected lands. However, where there is an agreement <br /> between the applicant/operator and the persons having an interest in the structure <br /> that damage to the structure is to be compensated for by the applicant/operator <br /> (C.R.S. 34-32-115(4)(d) ), then mining may occur within 200 feet. Proof of an <br /> agreement must be sLbmitted to the Division prior to the decision date. <br /> 4. No mining operation will be located on lands where such operations are <br /> prohibited by law (C.R.S. 34-32-115(4)(f) ) ; <br /> f <br /> 5. As the applicant/operator, I do not have any mining/prospecting operations in <br /> this state of Colorado currently in violation of the provisions of the Mined Land <br /> Reclamation Act (C.R.S. 34-32-120) as determined through a Board finding. <br /> 6. I understand that statements in the application are being made under penalty <br /> of perjury and that false statements made herein are punishable as a Class 1 <br /> misdemeanor pursuant to Section 18-8-503, C.R.S. <br /> Signed and dated this nr a' day of <br /> Applicant/Operator If Corporation Attest (Seal ) i <br /> By: � By. <br /> Title: Corporate Secretary or Equivalent <br /> Town/City/County Clerk <br /> State of <br /> ss <br /> County of _ , /,"u, ) <br /> The foregoing instrum nt was acknowledged before me thisrQA,/day of _ a44 I , <br /> n ,'1 <br /> by9 as 0 , . �11t ti _ of <br /> Notary Pub is <br /> 2921F (01 /91 ) My Commission expires: Q 3 <br />