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,' <br />-5- <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 an agreement between the <br />applicant/operator and the persons having an interest in the structure that damage <br />to the structure is 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 submitted 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)(f), C.R.S. 1984, as amended); <br />3. 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 Iand <br />Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through <br />a Board finding. <br />4. 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 1984, as amended. <br />Signed and dated this ~~ day of S[/~tic`Y'~ti~-ter I~~ ~J <br />P~QICK ~ou,,,rv ROAD `F QRIn~E <br />Applicant/Operator <br />If Corporation Attest (Seal) <br />Corporate Secretary or Equivalent <br />Tovn/City/County Clerk. <br />Title:~~~ ~+RlLt.taG~ LO~siACs+~.Ziz+ <br />State of ) <br />ss <br />County of ) <br />i ,n!_ <br />The foregoing instr/uJment was ac)vaowledged before me this ~ day of !7 y S <br />by IJ ~_ as ~(~~ of /~ <br /> <br />My Commission expires: <br />2ffi3F <br />(10!14!94) <br />