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S,§rti4iCitiori: ' <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> described has met the minlimm requirements of the following terms and conditions: <br /> I. This mining operation will not adversely affect the stab4ity of any significant, <br /> • valuable and permanent man-made atructuro(c) located within two hundred (206) Foot of <br /> the affected lands . (However, where there is an a reement between the <br /> applicant./npararor and the persons having an interest in thelIstructure that damage to <br /> 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 2C0 feet. <br /> Proof of an agreement must be submitted to the Officers ytior to :he deeisiaft date.) <br /> • 2. 170 mining operation will be located on lands where such gnArar.ions are prohibited <br /> by law (Section 34.32-115(4) (f) , C.R.S. 1964, 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 Lat:d <br /> Reclamation Act (Section 34-32-120, C.R.S. 1964, as amended) ere ;I=Le="ed through a <br /> Board finding. <br /> • <br /> 4. t understand that statements in the application are being made under penalty of <br /> perjury and that fain.^ ararfnents made herein are punishable as a Class i misdemeanor <br /> pursuant to Section 18-8-503, C.R.S 1984, as amended. <br /> Signed aucl dated this _ day os .• - , _LL <br /> I - <br /> pglicant/Operator If Corparatioa At s (Seal) <br /> • By: r By: � r� <br /> Corporates Secretary or Squivalent <br /> Titlo: dr <br /> Town/City/County Clerk <br /> State of <br /> • \ ) sc <br /> County of � <br /> The foregoing instrument vat acknowledged before me this . / `day ,of <br /> • by AI V \Qnsi as v <br /> ca <br /> WotarlIy Dubuc <br /> • my Commission expires: <br /> I <br /> • 2323F.wpf <br /> MVV" <br /> • <br />