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-5- <br /> •Certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> described bar met the minimw req•;r=e^ts 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 stz- cture 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) , tben mining may occur within 200 feet. <br /> Proof of an agreement mast 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 Land <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-S03, C.R.S 1984, as amended. <br /> Signed and da d this I� day of <br /> li /�/t�/Cperator If Corporation Attest (Seal) <br /> By: V" ` By: <br /> I/ p -511Lv. Cp ygte Secretary or <br /> I" <br /> Title: n V`� ���' �' Town/City/County Clerk. <br /> l ,Q State of L61ZADo ) <br /> ) ss <br /> County of L, LE A2 C2� K ) <br /> The foregoing instrument was acknowledged before me ✓t/h/ris ( n A day of /U� 2 �/,Y <br /> by C.Lrnt �,�„_ (�, . L¢(L a_ as VP --R/ . of irna�` //lit-Y. �� ..�yi,.m /n <br /> Notary Pub- ' <br /> My Commission expires: 2 <br /> 28MF <br /> (1U/l4fK <br />