Laserfiche WebLink
9 <br />VIII. SIGNATURE REQUIREMENT <br />Pleax place ou Initials on the line provided: <br />i <br />l1 I hereby verity 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 :pct and the rules as ,pecitied in the <br />Hard Rock Metal Mining Rules and Regulations and this VOI torm. <br />I have enclosed the required permit ree. <br />I authorize the Division to contact and copy the BI.M and-or USFS on any correspondence related to the prospecting <br />operation, if the prospecting operation is located on federal public land. <br />?!N 1 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 />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 :. <br />and C. R.S. 34-32-101. <br />This form has been approved by the ;tined Land Reclamation Board pursuant to section 34-32-113,C.R.S., of the ,Mined Land <br />Reclamation Act. Any alteration or modification of this form shall result in voiding any ;Vol issued on the altered or modified <br />form and subject the operator to cease and desist order. and civil penalties for operating without a .VOI pursuant to section 34- <br />32-123, C &S. <br />I the undersigned, being the NOI holder or the Orson authorized to sign on behalf of the N01-holder, declare that the information <br />given in this NO[ form is true and correct. <br />SIGNATURES MUST BE IN BLUE INK <br />Sighed and dated this day of <br />Signature of NOI holder or person authorized to sign: <br />Name (typed or print) <br />T'itleiPosition: <br />?1tt)!1'h!?'.?I<?25 SJ7T:L?')t_s,iZrm t'.'>.8'•!P.>_?rn<s ti(,li ='rcac