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-8- <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 terms and conditions: <br />1. This mining operation will not adversely affect the stability of any 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 for by the applicant/operator <br />(Section 834-32-115(4)(d), C.R.S. 1984, as amended), then mining may occur within 200 feet. Proof of an agreement must be <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 34-32-115(4)0, C.R.S. <br />1984, as amended); <br />3. As the applicantloperator, I do not have any mining/prospecting operations in this state of Colorado currently in violation of the <br />provisions of the Mined Land Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through a Board <br />finding. <br />4. I 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 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984, as amended. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-112,C.RS, of the Mined Land <br />Reclamation Act Any alteration or modification ofthis form shall result in voiding any permit issued on the altered or modfled form <br />and subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section 34-32-123, <br />C.R.S. <br />Signed and dated this day of Wo_ ?_ ' --so 70. <br />Wildcat Mining Corporation If Corporation Attest (Corporate/County Seal) <br />er or a <br />Signature: - By: <br />R° - I IC-??na? <br />Corporate Secretary or Equivalent <br />Title. Pt eyt ent Town/City/County Clerk <br />a <br />J <br />y N <br />-?.,p?L{•p/?. Al <br />p State of <br />'aa <br />S ) ss. <br />;,A County of. ) <br />S ? <br />The foregoing instrument was acknowled ed before me this 7` -- day of / VV040W- 24r,>10 <br />, <br />by as ?e of Wt <br />Not Public <br />=o?jYPWy? Notary Public State of Florida / <br />Kimberly E Lappin <br />?C? _ e` My Commission EE014410 My Commission expires: !D <br />%F tLe Expires 10/1012014