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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 />fo lowing terms and conditions: <br />t <br />1. This mining operation will not adversely affect the stability of any significant, valuable and permanent man-made structure(s) 4 <br />located within two hundred (200) feet of the affected lands. (However, where there is an agreement between the applicantloperator i <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)(f), C.R.S. <br />1984, as amended); <br />-JK 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 section 34-32-112,C.R.S., of the Mined Land <br />ReclamalionAct. Any alteration or modification of thisform shall result in voiding any permit issued on the altered or mod fed form <br />and subject the operator to cease and desist orders and civil penalties for operating rpith out a permit pursuant to section 34-32-123, <br />C.R.S. <br />Signed and dated this day of Aep 2,C a <br />Wildcat Mining Corporation If Corporation Attest (Corporate/County Seal) <br />Applicant/Operator Name <br />Signature: "%. ?1&. <br />Title: President <br />State of Colorado <br />Countyof La Plata <br />) ss. <br />By: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this 22 r?- day of Se n er 2-o 17 U <br />.JcjlNes M. <br />by JAth _ as President of Wildcat Mining Corporation <br />L91` D A MUNCH <br />NOTARY PUBLIC <br />a? ATE CF COLORADO <br />c--rYY'L' ' ^ .4'...^..V. Z <br />,d <br />Notary Public <br />My Commission expires:_ . ! < 'r 12-0 1Z