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.8- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation <br />fojkowing terms and conditions: <br />1. This mining operation will not adversely affect the stability of any signifi <br />located within two hundred (200) feet of the affected lands. (However, where <br />and the persons having an interest in the structure that damage to the structul <br />(Section 834-32-115(4)(d), C.R.S. 1984, as amended), then mining may oc( <br />submitted to the Office prior to the decision date.) <br />No mining operation will be located on lands where such operations are <br />1984, as amended); <br />described has met the minimum requirements <br />ant, valuable and permanent man-made structure(s) <br />there is an agreement between the applicant/operator <br />is to be compensated for by the applicant/operator <br />ur within 200 feet. Proof of an agreement must be <br />)rohibited by law (Section 34-32-115(4)(f), C.R.S. / <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 section 34-32-112,C.R.S., of the Mined Land <br />ReclamationAct. Any alteration or modication of this form shall result in voiding any permit issued on the altered or prod f 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 />CR.S. <br />Signed and dated this S 2- day of S 40t . <br />Wildcat Mining Corporation If Corporation Attest (Corporate/County Seal) <br />Applicant/Operator Name <br />Signature: yLt.. L <br />Title: President <br />State of Colorado <br />County of 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"" day of 5'e er 2-o ) V <br />f <br />.?Qmes M. <br />by. CA Mk as President of Wildcat Mining Corporation <br />STATE OF nn o Notary Public <br />LINDA MIB.NOH <br />Ia OTARY P?3BLIC <br />My Commission expires:__ 1 t J' -+ 12-C) 12