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Certl tioq: <br />As an authorized representative of the applicant, 1 hereby certify that the operation described has met the minimum requirements of the following <br />terms and conditions: <br />1. All necessary approvals from local government have been applied for (Rule 1.6.2(1) and (2)); <br />2. This entire mining operation will not extract more than 70,000 tons of mineral, overburden, or combination thereof in any <br />calendar year (defined in Rule 1.1(24)); <br />3. 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 and <br />the persons having an interest in the structure that damage to the structure is to be compensated for by the applicant/operator <br />(Section 34- 32- 115(4Xd), C.R.S. 1984, as amended), then mining may occur within 200 feet. Proof of an agreement must be submitted to <br />the Office prior to the decision date.) <br />4. No mining operation will be located on lands where such operations are prohibited by law (Section 34- 32- 115(4Xf), C.R.S. <br />1984, as amended); <br />5. 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 finding. <br />6. 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 />?Worm has been approved by the Mined Land Redamadon Board pursuant to section 34- 32- 110,GR.S., of the Mined Land <br />Reclamation Ad. Any alteration or modification of this form shall result in voiding any permit issued on the altered or modified fonts and <br />subjed the operator to cease and desist orders and fl vii penalties for operating without a permit pursuant to section 3432 -1Z3, RS <br />Signed and dated this <br />day of <br />State of Co bat cO ) <br />ss• <br />County of_02On!% ve, ) <br />-7- <br />It'Pvt rock 1 pfor°a tvo yr d i d OePe6pn1 f, <br />Applicant/Operator <br />Signed: ' <br />Title: <br />2of/ . <br />The foregoing instrument t was acknowledged before me this 1 4 day of -3--1 by Man �1 1 e s as P Ces; <br />SIGNATURES MUST BE IN BLUE INK <br />• <br />1 <br />• <br />• <br />If Corporation Attest (Seal) <br />Signed: Li- r 4, CA 1L <br />Corporate Secretary or Equivalent <br />Town/City /County Clerk <br />• 2n •l )eoelnprn <br />