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<br />-a- <br />7. The mining operation will not adversely affect the stability of any <br />significant, valuable, and permanent man-made structures located within two hundred <br />(200) feet of the affected lands, except 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 <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; <br />8. 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 />9. The mining operation will be conducted in accordance with the terms and <br />conditions listed in the application (Rule 3.3(1)(b)); <br />10. 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 />11. One complete copy of the application form and all exhibits, together with any <br />supplemental information provided by the applicant/operator to the Division has <br />been provided to the County Clerk and Recorder for each county in which affected <br />lands will be located (Rule 3.3(3)(a)); and, <br />12. 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 /~/6t/L~.C'L~ ~~Q~~ . <br />C A pli n Operator If Corporation Attest (Seal) <br />By: <br />Title <br />By: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of C\p (D~~td v ) <br />ss. <br />County of (~ c 5 ~ ) <br />The foregoing instrument was acknowledged before me this ~ ~ day of ~ (~ ~y ~/ <br />by~~~n ~~, ~ur~ne~E' as OwnE2 of ('Quctnl'~aC~ <br />A~P Q~ QeLI~CIG~c~ <br />Notary P lic <br />2820E (12/92) My Commission Expire slhdl~.+~?~+'~~a~+S-2'i~96 <br />