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Certification: <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 /> I.. This mining operation will not adversely affect the stability of any significant, <br /> valuable and permanent man-made structure(s) located within two hundred (200) feet of <br /> the affected lands . (However, where there is an agreement between the <br /> applicant/operator and the persons having an interest in the structure that damage to <br /> the structure is to be compensated for by the applicant/operator (Section <br /> 34-32-115(4) *(d) , C.R.S. 1984, as amended) , then mining may occur within 200 feet. <br /> Proof of an agreement must be submitted to the Office prior to the decision date.) <br />'Z* 2.' . No mining operation will be located on lands where such operations are prohibited <br /> by law (Section 34-32-115(4) (f) , C.R.S. 1984, 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 Land <br /> Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through a <br /> Board finding. <br /> 4. I understand that statements in the application are being made under penalty of <br /> perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br /> pursuant to Section 18-8-503, C.R.S 1984, as amended. <br /> Signed and dat this day of _ <br /> scant/Operator If Corporation Attest (Seal) <br /> Signed: ei ') C�_ <br /> Signed: EA <br /> �, . <br /> � Secretary or; fiquivalent <br /> Title: t,�, Ots e /�t �. ._ � - <br /> Town/City/County Clerk -_` - � — <br /> State. of <br /> s< County of <br /> The foregoing instrument was acknowledged before me this day of 9 <br /> c✓�f�9PSas /� C�'P.4e�4 �•� /y10� gDEy/v.Gl co <br /> Notary Public <br /> My Commission expires: / <br /> 2823Fdmaw+pf <br /> 00/I4/94) <br /> FEB 2 01997 <br /> F)iwirzian Rr r orior�yl�kv l;gology <br />