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RECE~'~i <br />Certification: <br />-~- <br />JAN Z 1 2003 <br />Division of Minerals and Geology <br />As an authorized representative of the applicant, I hereby certify that the operation described <br />has met the minimum requirements of the following terms and conditions: <br />1. This mining operation will not adversely affect the stability of any signi £icant, valuable <br />and permanent man-made structure(s) located within two hundred (200) feet of the affected <br />lands. (However, where there is an agreement between the applicant/operator and the persons <br />having an interest in the structure that damage to the structure is to be compensated for by <br />the applicant/operator (Section 834-32-115(4)(d), C.R.S. 1964, as amended), then mining may <br />occur within 200 feet. Proof of an agreement must be submitted to the Office prior to the <br />decision date.) <br />2. No mining operation will be located on lands where such operations are prohibited by law <br />(Section 34-32-115 (4)(f), C.R.S. 1984, as amended); <br />__. _3.___AS_the_applicantLoper~7.tor..,__L11o_not-have-any-mrni~q/prospecting-operations in t:~i~s state- <br />of Colorado currently in violation of the provisions of the Mined Land Reclamation Act <br />(Section 39-32-120, C.R.S. 1984, as amended) as determined through a Board finding. <br />4. Z understand that statements in the application are being made under penalty of perjury <br />and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to <br />Section 18-8-503, C.R.S. 1984, as amended. <br />Signed and dated this ~ day of ~,yv.[_~~,N.(J/~ oW~cs~ <br />Cl~mcx YVIelybdenum Cv. , ~ZVIC'~(°IrSi7rl I£ Corporation Attest (Corporate/County seal) <br />Applica t/Oper/~at~o r~Name /^~ o <br />Signature: ~~~~ii,Ga-~.~ ,~J ~ By: '^~ <br />pp \\ Q tf1 Co orate Secretar or Equivalent <br />Title: V ~Ge PI'es'~o~le~~Y (y. Geyt~Pal ~aYlc~f CY' Town/City/County Clerk <br />State of ~plh r~_) <br />County o£ ~~~ f`s,cyy~_ ) <br />~- <br />The foregoing instrument was acknowledged before me this ~ day of y~~ ,o~0a, <br />c- <br />byi ~` ~ ,`.: }~ f ~,7 0'~~"` ~~ ~ rn Li.)( h~ly ~F Aze Gt.hn <br />~Q~NpTARrv,,~p o T lA ~ lt"er,~s~ <br />~; + ~l~s~pC~ $ Notary Pub is <br />~~~~ p My Commission expires: S <br />fir.. <br />Lori S. Feuerbacher, Notary Pubic <br />M:\MIN\SHARE\VSFORMS\2a23FDM0.112 (10/15/Ol) State 0/ Colorado <br />My Commission Expires 2/15/2C+_! <br />