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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- 32.1I5(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 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. I understand that statements in the application aro being made under penalty of perjury and that false statements made herein are <br />punishable as a Class 1 misdemeanor pursuant to Section I8.8 -503, C.R.S. 1984, as am ended. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34- 32- 112,C.R.S, of the Muted .Land <br />Reclamation Act. Any alteration or mod cation of thisform shall result in voiding anypermtit issued on the altered or modledfornt <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 'L 'Z day of S , 7-0 i <br />Wildcat Mining Corporation If Corporation Attest (Corporate /County Seal) <br />Appliant/Operator Name <br />Signature: <br />Title: President <br />state of Colorado <br />County of La Plata <br />- 8 - <br />s« h 1 1 By <br />The foregoing instrument was acknowledged before me this 2Z NI day of Sep &YW e r , 2-b J 0 .cue3 M. IT <br />by crievtirg.5 as President o f Wildcat Mining Corporation <br />LINDA MUNCH <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />ti <br />1 <br />Corporate Secretary or Equivalent <br />Town /City /County Clerk <br />My Commission expires: <br />Notary Public <br />��� 0'12.012- <br />