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'S- <br /> Certification: <br /> As an authorised 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 wi$l 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 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 18-8-50/3, C.R.S 1984, as amended. <br /> Signed and dated this day of <br /> //ICJi.O Sin /YO dFr l if'S <br /> Applican operator If Corporation Attest (Seal) <br /> By By: <br /> � Corporate Secretary or Equivalent <br /> Title: (90keYa / rTn P✓ Town/City/County Clerk. <br /> State of CUtRAIDO ) <br /> ss <br /> County of GkWP <br /> The foregoing instrument was acknowledged before me this ! day of <br /> by KON 11 IN ft o�1 as 2 FAr� of <br /> Not&T Publi 2 <br /> my commission expires. <br /> 2223F <br /> (10/14/94) <br />