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9 (forth 2- Public) <br />VIII. SIGNATURE REQjWMENT <br />Please you initials on the line provided: <br />I hereby verify that the foregoing information is true and accusato 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 BLM and/or USFS on any eorucspondence 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 tests of reclamation. <br />I understand that I am not authorized to create any surface disturbance until the surety wu nt is posted and approved <br />in writing from the Division of Reclamation, Wkung and Safety. <br />I accept and agree to comply with the foregoing tenors and conditions and with an of the provisions of Rules 3 and 5, <br />and C.R.S. 34-32.141. <br /> <br />TAak farce Arcs beau arprvi erd by Ae Mhwd Land Red= w eve Doe rd p uma# to sextma 34-3Z 114 CAS., of tee MhW Laced <br />RedanWon Ad Any auere&N or modVcadow of Ak farce skaO reach In vo&ftg any NOI issued on dke aftW or M04W <br />form nand swh jad dire opentar to dense and chest ardas and chdpawilafor 4peraftV vsdwW a N01 prrsamrt to se cwn 34- <br />32-123, CJtA <br />sign an behalf of t1a I Wider. fteb-m that <br />given in this NOI form is true ang1ZM3NL <br />SIGNATURES MUST BE IN BLUE INK <br />Signed and dated this _ 14t? day of JrU» - 2Q/D , <br />Signature of NOI holder or person authorized to sigt: <br />Name (typed or Print) h6xt D AL1w <br />XMi L\tl ?nfarm07.07-01 vsfortnslPrososctina f2rms\140I ProsRg!tiagARg. 92a4 U?