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9 (Form 2- Public) <br />VIII. SIGNATURE REQUIREMENT <br />Please place you initials on the tine provided: <br />I 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 Mining Rules and Regulations and this NOI form. <br />I have enclosed the required permit fee. <br />I authorize the Division to contact and copy the BIM 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 />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 form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-113, C.&&, of the Mated Land <br />Reclamation Act Any alteration or mod y7cation of this faro: shall result in voiding any N01 issued on the altered or modyled <br />form and subject the operator to cease and desist orders and civil penalties for operating without a N01 pursuant to section 34- <br />32-123, C.RS <br />I the undersigned being the N01 b-old_ er or the person authorized to sign on behalf of the NOI holder declare that the information <br />given in this NOI form is true and correct ?'- <br />SIGNATURES MUST BE IN BLUE INK <br />$ignedaW..dat4d ibis 10 ^0 day of <br />Signature of NOJ holder or p n authorized to sign: <br />Name (typed or print) Richard S. ykitta <br />Title/Position: Operations Manager <br />t rfL?it??lsalgivsfig o7871}f v?foar ?Pmvicectins fortes urJl PtosaectineAav 07,24ZD7