Laserfiche WebLink
<br />c) <br />Plezse place y-3iu initials on the tine: provided: <br />l hereby verify that the information is true and accurate: and corninil to the reclamation of the <br />afar-mentiontcl prospecting Ji,-. ;,; r, c aired by the C'olc,mdo Mined R,- .+ -;-nn Fact and the rules as - ec.ified in the <br />Hard Rock tilet.d %lining Rules vnc: Regulations and this NO tbrnt. <br />1 have enclc<<d the required permit fee. <br />t aufliorire fire Division to crm,N t anci copy the SL.M and/or USES on any correspondence related to the prospecting <br />t >er>?ta4."t. ypect*l -, is located on federal } 3.blal?, land, <br />- - ? t have also ?;uulosed the apptop, iaae reclatrration surety amount or will post an aniount as determined by the: vft'tce:, <br />based on the prgjected costs ofrec lane: t on. <br />?u t understand that t am not authorited to create any surface disturbance until the surety amount is posted and approved <br />in writin, from the Division of Reclamation. Notting and Safety. <br />t accept and agree to comply with the foregoing terms arts conditions and with all of the provisions of Rules 3 and 5. <br />and C.R.S. 34-32-101. <br />nis farm ltas been approved kt, the Alluerd Land Reclamation Board pursuant to section 34-32-I13,C R S'., of they Alive d Land <br />Recd'anacrtion Act. Any. alteration or rnod eata'on of this fortu sliall result in voiding, any NON issued on the alb,red or ntodied <br />faun and subject the operator to cease and desisa orrlerc and civil penetlfies for raperatin'wiflraut a ,VOl pursuaut ua sez.tinra 34- <br />32-12-3, C R-.S. <br />1. the utadersi =netl. bei the ",? ,O1 holder of thc_p r<<,ri, authorized to sitasa on behalf of the *.C?.t.._holder. declare that the information <br />udven in this NO[ form is true aad correct. <br />SIGNATURES MUST BE I BLUE INN <br />Si-ned and dated this <br />clay of Si-nature of NOI holder or person atafl; w€zed Lo sib: <br />% - <br />Nante i,?oedorprint1 <br />";;"sat Alb <br />?- <br /> <br />U <br />r? <br />•