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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 m+~+~+m requiremeata of the following terms and conditions: <br />1, This mining operation riil not adversely affect the stability of nay <br />sigaificaat, valuable and pe*+~=^~~t man-made structure(s) located rithia tro hundred <br />(200) feet of the affected lands. (Horever, rhere there is as agreement betreea the <br />applicant/operator and the persaae having as 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 rithia 200 feet. <br />Proof of an agreement must be submitted to the Office prior to the decision date.! <br />2, No mining operation rill be located oa lands rhere such operations are <br />prohibited by lar (Sectiaa 34-32-115(4)(f), C.R.S. 1984, as amended); <br />3. As the applicant/operator, I do not have nay mining/prospecting aperatiana in <br />this state of Colorado currently in violation of the provisions of the Mined *__d <br />Reclamation Act (Section 34-32-120, C.R.S. 1984, ae amended) as determined through <br />a Board finding. <br />4. I understand that statements is the application aze 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 1984, as amended. <br />Signed sad dated this T d/a~y of ~C~C~mdJ~~ <br />// ~j.~%'~// <br />Title: (~iL'i7C~/to~ ~ ~~~ UilCs-~'cG,.1 <br />!^~~ <br />State of ) <br />ss <br />County of ) <br />If Corporation Attest (Seal) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk. <br />The foregoing inst*++T~++t ras ackaorledged before me this . ~ ~ day of~l ECER'(13E IZ , ~, <br />by KILI~~ NiE15eN as l~EnIEP~I IIhFf`(AQ~ of Am~cea(~~~.~.1.~. . <br />„~ Notary Public <br />My Commission expires: S I I9 IaOO~ <br />5v~'.~jEP ' °o <br />Y~O° :'~~ <br />;•o <br />grEe=~~ <br />Qu.~e <br />2873F <br />(10/14!94) <br />