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7 - <br /> Certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation described <br /> has met the minimum requirements of the following terms and conditions: <br /> 1. 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 the <br /> affected lands. (However, where there is an agreement between the applicant/operator and the <br /> persons having an interest in the structure that damage to the structure is to be compensated <br /> for by the applicant/operator (Section 834-32-115(4) (d) , C.R.S. 1984, as amended) , then mining <br /> may occur within 200 feet. Proof of an agreement must be submitted to the Office prior to <br /> the decision date. ) <br /> 2. No mining operation will be located on lands where such operations are prohibited by law <br /> (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 this state <br /> of Colorado currently in violation of the provisions of the Mined Land Reclamation Act <br /> (Section 34-32-120, C.R.S. 1984, as amended) as determined through a Board finding. <br /> 4 . I understand that statements in the application are being made under penalty of perjury <br /> and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to <br /> Section 18-8-503, C.R.S. 1984, as amended. <br /> 7 �� <br /> Signed and dated this V day of r{ ✓L4✓�i , �l <br /> If Corporation Attest (Corporate/ unty Seal) <br /> Applicant/Operator Name <br /> Signature: Xgy_ C <br /> „� K� � ��v1 d/2,/f� Corporate Secret`r Equivalent <br /> CTit1e: ff(°E /PSi E' ;�j <br /> � Town/City/County Clerk. <br /> State of . A-PU ) f '- <br /> ss. <br /> County ofie <br /> The foregoing instrument was acknowledged before me this o_)7d ay of _ F L��u *'e <br /> i <br /> by of C_ Z MAX I970GV,6,b dA sll <br /> Notary Public <br /> My Commission expires <br /> M:\MIN\SHARE\VSFORMS\2823FDM0.112 (07/27/98) <br />