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<br /> <br />-4- <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. All necessary approvals from local government have been applied for <br />(Rule 3.2(1)(d)>; <br />2. This entire mining operation will not extract more than 70,000 tons of <br />mineral, overburden, or combination thereof in any calendar year (Rule 3.2>; <br />3. Tnis mining operation will not adversely affect the stability of any <br />signifi~:ant, valuable and permanent man-made structure(s) located within <br />two hun~tred (200) feet of the affected lands. However, where there is an agreement <br />between the applicant/operator and the persons having an interest in the structure <br />that darnage to the structure is to be compensated for by the appiicant/operator <br />(C.R.S. 34-32-115(4)(d)), then mining may occur within 200 feet. Proof of an <br />agreement must be submitted to the Division prior to the decision date. <br />4. No mining operation will be located on lands where such operations are <br />prohibited by law (C.R.S. 34-32-115(4)(f)); <br />5. 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 (C.R.S. 34-32-120) as determined through a Board finding. <br />6. 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. <br />Signed and dated this ~~ day of <br />ApplicantlOperator <br />By: ~~~7 <br />Tit 1 e : ~~-n-f~~ <br />State of t.~ ~-r"~"~-~' ) <br />) SS <br />County of ~~ ) <br />~~~ ~. <br />If Corporation Attest (Seal) <br />By: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me thisp~~ay of~~, /2- <br />by ~ fc~rd~ 51~17s as ('~cA%vleu of L1 Si~a~s Gy~xl ~o. <br />Q~G <br />No Public G <br />2821E (11/91) My Commission expires: ,~ ` 3 ~/ S~ <br />