2011-11-01_REVISION - P2008046 (6)

Home Browse Search

VIII. SIGNATURE REOUIREMENT Please place you initials on the line provided: I hereby verify that the foregoing information is true and accurate and commit to the reclamation of the aforementioned prospecting site as required by the Colorado Mined Reclamation Act and the rules as specified in the } Hard Rock/Metal Mining Rules and Regulations and this NOI form. I have enclosed the required permit fee. I authorize the Division to contact and copy the BLM and/or USFS on any correspondence related to the prospecting �� /r o peration, if the prospecting operation is located on federal public land 4 X�: t ., have also enclosed the appropriate reclamation surety amount or will post an amount as determined by the office, 1 based on the projected costs of reclamation. 4 _ I understand that I am not authorized to create any surface disturbance until the surety amount is posted and approved �� in writing from the Division of Reclamation, Mining and Safety. I accept and agree to comply with the foregoing terms and conditions and with all of the provisions of Rules 3 and 5, and C.R.S. 34-32 -101. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32-113, CRS., of the Mlned Land Reclamation Act Any alteration or mod cation of this form shall result in voiding any NOl issued on the altered or mod led form and staled the operator to cease and desist orders and dvil penalties for operating without a NOl pursuant to section 34- 32 -123, CR.S. 1. the undersigned. being the NOI holder or the person authorized to aiim on behalf of the NOI holder. declare that the information given in this NO1 fern, is true and correct. Signed and dated this 2 7 day of CA: 74 / 2c Signature of�NO1 holder or person authorized to sign: 0, 401 9 (Form 2- Public) SIGNATURES MUST BE IN BLUE INK f L Name (typed or print) / cif' f' / Title/ Position: IVP / G` t limn e.Oatk o 47 . j) vsfu s\P+ nwciiegf t;YUl Prospectingl►pp..olaii91