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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 <br />structure(s) located within two hundred (200) feet of the affected lands. (However, where there is an agreement between <br />the applicantloperator and the persons having an interest in the structure that damage to the structure is to be compensated <br />for by the applicant/operator (Section 834- 32- 115(4xd), C.R.S. 1984, as amended), then mining may within 200 feet. <br />Proof of an agreement must be 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(4Xf), <br />C.R.S. 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 <br />of the provisions of the Mined Land Reclamation Act (Section 34 -32 -120, C.R.S. 1984, as amended) as determined <br />through a Board finding. *(See below.) <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein are 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 Reclmnation Board pursuant to Section 34 -32 -112, C.R.S., of the Afined Land <br />Reclamation Act. Any alteration or modification of this form shall result in voiding any permit issued on the altered or nrodifred form <br />and subject the operator to cease and desist orders and civil penalties far operating wit /tout a permit pursuant to Section 34-32-123, <br />C.R.S. ,` Signed and dated this % 0 4, day of , L(,� �1J <br />Cotter Co oratio S.L. If Corporation Attest (Corporate/ County Seal) <br />AP -c rat Name <br />Signature: By: <br />J _ <br />4 Corporate Secretary or Equivalent <br />Title: �ioc,4 Touvt/City /County Clerk <br />Stateof <br />)ss. <br />County of Sal- <br />The foregoing instrument was acknowledged before me this <br />Al. -/om' <br />/0 day of / � d, o <br />�@/itf &T-ft J. hR <br />by as P%eng4oti of ltd t ��l <br />Notary PVblic <br />JENNIFER R. LEAR y y <br />Comm. 111990755 <br />(� My Commission expires: <br />NOTARY E OSM DIEGO COUNTY <br />Nt' Cotw. Ev. SEP. 10, 2016 <br />SIGNATURES MUST BE IN BLUE INK <br />*An exception is that the Mined Land Reclamation Board ("Board ") issued Findings of Fact, Conclusions of Law, and Order, in the matter of Cotter <br />Corporation's Possible Violations, Cease and Desist Order, Corrective Actions, and Civil Penalties, File No. M- 1977 -300, Notice of V iolation No. MV- <br />2010-013, dated August 11, 2010, as amended September 2012, relating to the ScInvartnvalder Mine. This exception, however, is being resolved through <br />an Agreement between Cotter Corporation (N.S.L) and the Colorado Division of Reclamation, Mining and Safety entered into on September 12, 2012 <br />(-AS. ­.V) .t") for add —i.s conditions at the Schwart—alder Mine and through Application Amendment 4 to Mine Permit M- 1977 -300. The Board has <br />approved the foregoing Agreement. In that Agreement, Cotter made no admissions. <br />