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9 (1=corm ?- Yublic) <br />VIII. til(:y:~'fl'1ZF: IZ1~:(~1i111F:~'IEVT <br />Please place you initials on the line provided: <br />.." ' ~ t 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 Act and the rules as specified in the <br />Hard Rock'Metal Mining Rules and Re~~ulatiuns and this NOl forn~. <br />l~~~r .f 1 have enclosed the required permit fee. <br />~~/ _~ ~ { I authurire the Division to contact and copy the E3LM and.'or l'SFS on any correspondence related to the prospecting <br />operation, if the prospecting operation is located on federal public land. <br />L L %`r I have also enclosed the appropriate reclamation sureh amount or will post an amount as determined by the office, <br />haled on the projected costs of reclamation. <br />l ~~~~t I understand that 1 am nut authorized to create any surface disturbance until the surety amount is posted and approved <br />in +vriting from the Division of Reclanuttion, Mining and Safety. <br />/. 1 L <br />l ~'%~ ~ I accept and agree to comply +vith the foregoing terms and conditions and +vith all of the provisions of Rules ~ and 5, <br />and C'.R.S. ,.t-;?-101. <br />7'hi.+.firrrn bus hC~n upprurc'd ht' tke Alined /.curd Rc~clrrnurtiurt Buarrl pursuurrl t« .+cctiurr 34-.iZ-1 / i, ('.R..S., of Ilre ;ti/irrc~d Lrard <br />Reclamation . Ict. .4n}' « lterution ur nwdificcuinn r jtlri.+,(urrn .+11u11 re+uh irr voiding acct' .~'O! is.+ued un the altered ur nurdified <br />.furnr and subject t/rr ope~ruror to ceu.+~e rnul rlesict urrlers unrl ci,d/ perrulties %ur uperrrtirrg ,ti~ithuut rr ;1'(1/ prrrcuunt to sccliu-r .i4- <br />32-1?3, ('. K.S. <br />I the undersir;ned being the NOI holder or thepersun authorized to si~~n on behalf of the NOI holder, declare that the information <br />given in this NOI form is true and correct. <br />til(~`;~"I l'IZI~:S ~11(~ti'I~ Ii F, IN BLI'F: I\F~ <br />.J/ ~ <br />Signed and dated this day of vet ~' <br />Signature of NOI holder or person authorized to sign: <br />/ ~-, <br />C L ll ~tG~' r ~ . ~ ~ 1.~ ll ~ r,r << <br />~~ / / <br />~ ~/!!/// (/J C C./~ //5 <br />Name (typed ur print) l ~ <br />nun`ah.uclvaimnsU)7-07-U1 vsii,rms\PmspccUngti~nns`,NOI E'rospccUnr:lpr 07+'24107 <br />