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(FORM 2 - Public filing) <br />VIII. SIGNATURE REQUIREMENT <br />Please p e you initials on the line provided: <br /> 1 hereby verify that the foregoing information is true and accurate and commit to the reclamation of the <br /> aforementioned prospecting site as required by the Colorado Mined Reclamation Act and the rules as specified in the <br /> Hard Rock/Metal Mining Rules and Regulations and this NOI form. <br /> I have enclosed the required permit fee. <br /> <br /> I authorize the Division to contact and copy the BLM and/or USFS on any correspondence related to the prospecting <br /> operation, if the prospecting operation is located on federal public land. <br /> I have also enclosed the appropriate reclamation surety amount or will post an amount as determined by the office, <br /> based on the projected costs of reclamation. <br /> I understand that I am not authorized to create any surface disturbance until the surety amount is posted and approved <br /> in writing from the Division of Reclamation, Mining and Safety. <br /> I accept and agree to comply with the foregoing terms and conditions and with all of the provisions of Rules 3 and 5, <br /> and C.R.S. 34-32-101. <br />I herby certify that concurrent with submittal of this NO[ to the Division, I have sent notice to the Boards of County <br /> Commissioners in the Counties where the proposed activities will occur. This notice also indicated that non-, <br /> confidential information regarding the proposed activities will be available for review at the Division's website. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-113, C.R.S, of the Mined Land <br />Reclamation Act. Any alteration or modification of this form shall result in voiding any NOI issued on the altered or modifled <br />form and subject the operator to cease and desist orders and civil penalties for operating without a N01 pursuant to section 34- <br />32-123, C.R.S. <br />given in this NOI form is true and correct. <br />SIGNATURES MUST BE IN BLUE INK D <br />Signed and dated this day of ?Y4Y® <br />Signature of NOI hold person authorized to sign: <br />4/V/S 0 ?S0Aj <br />??? ?? Mq ??N <br />Ery , <br />Name (typed rint) Lawrence J. O'Connor <br />Title/Position: President/St. Sophia Holding Ltd.