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Certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> .described has met the minimum requirements of the following terms and conditions: <br /> 1.. This mining operation will not adversely affect the stability of any significant, <br /> valuable and permanent man-made structure(s) located within two hundred (200) feet of <br /> the affected lands . (However, where there is an agreement between the <br /> applicant/operator and the persons having an interest in the structure that damage to <br /> the structure is to be compensated for by the applicant/operator (Section <br /> 34-32-115(4) '(d) , C.R.S. 1984, as amended) , then mining may occur within 200 feet. <br /> Proof of an agreement must be submitted to the Office prior to the decision date.) <br /> 2. No mining ng operation will be located on lands where such operations are prohibited <br /> by law (Section 34-32-115 (4) (f) , C.R.S. 1984, as amended) ; <br /> 3. As the applicant/operator, I do not have any mining/prospecting operations in <br /> this state of Colorado currently in violation of the provisions of the Mined Land <br /> Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through a <br /> Board finding_ b. <br /> 4. I understand that statements in the application are being made under penalty of <br /> perjury,and that false statements made herein are punishable as a Class 1 misdemeanor <br /> pursuant to Section 18-8-503, C.R.S 1984, as amended. <br /> g q�Signed and dat this �/�'"' . day of <br /> icant/Operator If Corporation Attest (Seal) <br /> Signed: Signed: <br /> Secretary or Equivalent <br /> Title: JA& Q�.GS'�,�.,# l f L — <br /> tom-Town/City/County Clerk <br /> State. of ���'� <br /> ) <br /> ss <br /> g County of ) <br /> 9 a <br /> The foregoing instrument was acknowledged before me this � day of �! <br /> t. <br /> aseaera . BDEyt�,y c� <br /> Notary Public <br /> FFB 2 0 1997 My Commission expires: <br /> 23Fdmnwpf _ <br />