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-`t- <br />Certification: <br />As an authorized representative of the applicant. I hereby certify that the operation described has met the minimum requirements of the <br />following terns and conditions: <br />1. This mining operation will not adversely affect the stability ofany significant, valuable and permanent man-made structure(s) <br />located within two hundred (200) feet of the affected lands. ( However, where there is an agreement between the applicant operator <br />and the persons having an interest in the structure that damage to the structure is to be compensated tier by the applicant: operator <br />(Section 534-32-I l5(4)(d), C.R.S. 1954, as amended), then mining may occur within 200 feet. Proof of an agreement must he <br />submitted to the Office prior to the decision date.) <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32-1 15(4)(1), C.R.S. <br />1984, as amended): <br />3. As the applicant/operator. I do not have any mining/prospecting operations in this state of Colorado currently in violation of the <br />provisions of the Mined [.and Reclamation Act (Section 34-32-120, C.R.S. 1954, as amended) as determined through a Board <br />finding. <br />4. 1 understand that statements in the application are being made under penalty of perjury and that false statements made herein are <br />punishable as a Class I misdemeanor pursuant to Section i X-8-50's, C.R.S. 1954, as amended. <br />This./'arm has been approved ht' the Mined Lund Reclamation Board pursuant to section 34-32-112,CR.S., oj'the Mined Land <br />Rec•lantation I ct.. I nY alteration or modijication of this lornt ;hall result in voidim, attV perotit issued on the altered or tit odilied (arm <br />(tnd ;uhjec•t the operator to cease and desist orders and civil penalties for operatitt"? without it permit pursuant to section 34-32-123, <br />C.R..S. <br />Signed and dated this '_ 0 fy-) day of A/10- "I 2ool- <br />'Denison Mines (USA) Corp. I(Corporation Aties (CorporatC/County Seal) <br />Applicant:Operator Name <br />Signature: - Bv: <br />ratC Secretary or Equivalent <br />/ C041 <br />'9itle: Towlv'C'ityr'County Clerk <br />Stateof Cc?)D?aQo ) <br />County of (z) Ut°, V-- ) <br />2di?>' z <br />The foregoing instrument was acknowledged before me this day of AA ;1'L1 v <br />byN')L &ZLL as 1 ?1ItY' of /llSl' /?? d1PSlIjY1?Cni)J' l <br />Notary Public <br />My Commission expires: ???