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9 C~,,~ ~, h~tic~,~J <br />VIII. SIGNATURE REOLIREME:NT <br />Please place you initials on the Line provided: <br />,~,~'~ 1 hereby verify that the foregoing information is true and accurate and commit to the reclamation of the <br />aforementioned prospecting site as required by the Colorado Mined Reclamation Act and the rules as specified in the <br />Hard Rock:'Metal dining Rules and Regulations and this NOi form. <br />._~ 1 have enclosed the required permit fee. <br />_~,~_ [ aut:llorize the Division to contact and copy the BLM andbr USFS on any correspondence related to the prospecting <br />rr // operation; if the .prospecting operation is located on federal public Sand. <br />~~1"f I have also enciosed the appropriate reclamation surety amount or will post an amount as determined by the offyce, <br />based on the projected costs of reclamation. <br />t understand that [ am not authorized to create any surface disturbance until the surety amount is posted and approved <br />in writing from the Division of Reclamation, Mining and Safety. <br />~S,f ~_ 1 accept and agree to comply with the foregoing terms and conditions and with all of the provisions of Roles 3 and S, <br />and C.R.S. 34-32-Ipl. <br />This form Itas been approved by the Mined Land Reclamation Bourd pursuant to section 34-32-113,0 IZS., of the Mined Land <br />Reclamation Art. Any alteration or modification of this firrnr s/ru// result in voiding any NDI issued on the altered ar n:odifted <br />form and subject the operator to cease and desist orders and civil penalties free operating without a :VOJ pursuant to section 34- <br />32-123, C.RS. <br />1, the undersigned, being the NOI holder or the person authorized to sign on behalf of the tv01 bolder declare that the information <br />given in this NOI farm is true and correct <br />SIGNATURES MUST BE IN BLUE INK <br />Signed and dated this 19tH day of May, Zoos <br />Signature of NOi holder or person authorized to sign; <br />D Na.,~;/~.~ <br />Name {;typed or print) -----, Don_ Hamilton ___,,,,,_._....._.....__.w___._....._...._..__._... <br />Title/Politic>n: Agent <br />>rrxinG~sts~re`w.4a#orii,~t7-(i1-~}~_,;<formlF'r~iin~fornt~!'~f)I Pr~zs inQ ~zr. tr'it~%ti^ <br />