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9 (Form 2- Public) <br />VIII. SIGNATURE REOUIREMENT <br />Please place you initials on the line provided: <br />I hereby verify that the foregoing i.nfortnation 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 Mining Rules and Regulations and this NO.I form. <br />.G I have enclosed the required permit fee. <br />I authorize the Division to contact and copy the BLM and/or USFS on any correspondence related to the prospecting <br />operation, if the prospecting operation is located on federal public land. <br />I have also enclosed the appropriate reclamation surety amount or will post an amount as determined by the office, <br />based on the projected costs of reclamation. <br />G I understand that I 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 />I accept and agree to comply with the foregoing terms and conditions and with all of the provisions of Rules 3 and 5, <br />and C.R.S. 34-32-101. <br />This fora has been approved by the Mined Land Reclamation Board pursuant to section: 34-32-.113, C.R.S., of the Mitred Land <br />Reclamation Act. Any alteration or modification of this fornn shall result in voiding any ]V01 issued on the altered or modified <br />fornn and subject the operator to cease and desist orders and civil penalties for operating without a NOI pursuant to section 34- <br />32-123, C.R.S. <br />1, the undersigned, being the NOI holder or the person authorized to sign on behalf of the NOI holder, declare that the information <br />given in this N01 form is true and correct. <br />SIGNATURES MUST BE IN BLUE INK <br />Signed and dated this day of -- 44-4941,4Z 2 <br />Signature of NOI holder or person authorized to sign: <br /> <br />Name (typed or print) _Richard Cherry <br />- .............. - <br />TitleJPosition: President & CEO <br />trrEin'` ht!'e`cf.:i,SfCf7-0' ui v9fz711T Pg. 012 <br />?i? r