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0 Certification: <br />-8- <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the <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/operator <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)(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 of the <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. 1 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 I 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 3¢32-112,C &S., of the Mined Land <br />Reclamation Act Any alteration or modification of this form shall result in voiding any permit issued on the altered or modified 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.S. <br />Signed and dated this ?2dJ A day of June 2011 <br />Cotter Corporation (N. S . L .) If Corporation Attest (Corporate/County Seal) <br />Applicant/Operator Name <br />Signature: By:_ 4)V,a L ^ t <br />Glen Williams Corporate Secretary or Equivalent <br />Vice President, Mining Operations <br />Title: Town/City/County Clerk <br />State of -tc/«.4d. ) <br />) ss. <br />County of /)h),i --r.o-OE ) <br />The foregoing instrument was acknowledged before me this -t ,:f day of ?1.:•L '. C// <br />by,7k , r.: l l ..l'rn S as &',e. r'r-J43 of iNI. Pi-. f q lz'010-1 <br />l)GRO7 0, ?:. <br />Notary Public <br />Commission expires: ;i ;j r - 1.