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Certification: <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)(f), 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 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,CR.S., of the Mined Land <br />ReclamationAct. Any alteration or modification ofthis form shall result in voiding any permit issued on the altered or ntodified 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 Z. 2 - day of S `t , <br />Wildcat Mining Corporation If Corporation Attest (Corporate /County Seal) <br />Applicant/Operator Name <br />Signature: By: <br />P resident Corporate Secretary or Equivalent <br />Title: Town /City /County Clerk <br />State of Colorado <br />County of La Plata <br />) ss. <br />The foregoing instrument was acknowledged before me this <br />...\citrnne3 M. <br />by e1eMe143 as President o f Wildcat Mining Corporation <br />LINDA MUNCH <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />- 8 - <br />2Z Y"d- day of S.e tuber , 2 01 U <br />My Commission expires: <br />Notary Public <br />I1) l -12012 <br />