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9 (Form 2 - Public) <br />VIII. SIGNATURE REQUIREMENT <br />Please place you initials on the line 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 />1 have enclosed the required permit fee. <br />I authorize the Division to contact and copy the BLM and/or USFS on any correspondence related to the prospecting <br />operation, if the prospecting operation is located on federal public land. <br />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 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.R.S., of the Mined Land <br />Reclamation Act. Any alteration or modification oJ'this form shall result in voiding anV NOI issued on the altered or modified <br />form and subject the operator to cease and desist orders and civil penalties for operating without a NOI pursuant to section 34- <br />31-123, C.R.S. <br />I, the undersigned, being the NOI holder 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 />Signed and dated this It 171 day of Au4vST 7009 <br />Signature of NOI holder or person authorized to sign: <br />•PI <br />Name (typed or print) Charles V. Muerhoff <br />'Title/Position: Vice President <br />MlVn6sharOvsforms107-07-01 vsfQnnSTrosoecting t'urms\NO1 Prospecting App 07/24/07