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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 ofthe <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/opemtor <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(4xd), 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 applicant/operator, I do not have any mining/prospecting operations in this state of Colorado currently in violation ofthe <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 secdon 34-32-112,CRS, of the Mined Land <br />Reclamation Act Any alteration or madiftcadon of this form shall result in voiding any permit issued on the altered or mvdifi;ed 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.& <br />Signed and dated this 141* day of DWR aw . <br />Wildcat Mining Corporation If Corporation Attest (Corporate/County Seal) <br />Applicant/Ope r e <br />Signature By <br />? <br />Title: President <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of 11 ) <br />o ) ss. <br />County of -S?A ) <br />The foregoing instrument was acknowledged before me this I + - day of `o o <br />b} C '{)C '?ZE5i77EEt.1of 1A? Q1 1-(lOits4 Ll -1DI,,J <br />n?? Notary Public state or Florida Notary Public <br />ap Kimberly E l.appin WI <br />My Commotion EE014410 My Commission expires: <br />'?Of t? Expires 10/1012014