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'S- <br />' Certification: <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. This mining operation will not adversely affect the stability of any <br />significant, valuable and permanent man-made structure(s) located within two hundred <br />(200) feet of the affected lands. (However, where there is as agreement between the <br />applicant/operator and the persona having an interest in the structure that damage <br />to the structure ie to be compensated for by the applicant/operator (Section <br />834-32-115(4)(d), C.R.S. 1984, as amended), then mining may occur within 200 feet. <br />Proof of an agreement must be sukmitted to the Office prior to the decision date.) <br />' 2. No mining operation will be located on lands where such operations are <br />prohibited by law (Section 34-32-115(4)(£), C.R.S. 1984, as amended); <br />3. As the applicant/operator, I do not have any mini.ngfprospecting operations in <br />this state of Colorado currently in violation of the provisions of the Mined Land <br />Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through <br />a Board finding. <br />4. Z 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 1984, as amended. <br />' Signed and dated this ,.,~~ day of ~~~.Ir, o n ~~~ . <br />1 <br />1 <br />State of ~r~IrX,~,~n _ ) <br />sS <br />COUnty Of ) <br />The foregoing instrument was aclmowledged <br />by tell ~~~I1 as <br />2E2iF <br />(10!14194) <br />If Corporation Attest (Seal) <br />sy: /~ ~ ~~ <br />UCo rate Sec tart' or &guivaleat <br />Town/City/Co~ Clerk. //~~11 <br />~~~ d o-~ ~ (drnMiS~iarF <br />before me this day o£ / t ! /~, <br />(1 aF tn'~- of <br />Not Publ' c - <br /> <br />Title: ~~i ~ ~n`~, , N~l~rN1 r II i.S'f(-G`FFl t- <br />