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i <br />-4- <br />• <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. This mining operation will not adversely affect the stability of any <br />significant, valuable and permanent man-made structure(s) located within <br />two hundred (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 damage 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 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 MARCH , <br />Applicant/Operator If Corporation Attest (Seal) <br />BY: ~<~~y%~ ~~ By: <br />Title: owNER Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />$tdte Of COLORADO ) <br />55 <br />County Of DOUGLAS ) <br />fti ! °S <br />The foregoing instrument was acknowledged before me this day of Y`r~AJ~~,I~ „ I <br />by J~K ~,. l~uiNtil as c~a~iflz of (~u <br />F <br />~OUISE BAUER <br />Notary Public ar 1 i c <br />2821 F (08/91 ) State of Colorado <br />y Commission expires: 1 i <br />