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665423 08 -12 -2013 03:11 pN Fuse 7 of 18 <br />-7- <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. All necessary approvals fiom local government have been applied for (Rule 1.62(1) and (2)); <br />2. This entire mining operation will not extract more than 70,000 bons of mineral, overhirden, or combination thereof in <br />any calendar year (defined in C.R.S. 3432- 110(2xa)); <br />3. This mining operation will not adversely affect the stability of any significant, valuable and permanent man -made <br />stmchue(s) located within two hundred (200) feet of the affected lands. (However; where there is an agreement between the <br />applicardoperator and the persons having an interest in the structure that damage to the shuctm is to be compensated for by the <br />applic�nt/opaatm (Section 3432- 115(4xdl C.R.S. 1984, as amended), then mining may occur within 200 feet. Proof of an <br />amt must be submitted to 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), <br />C.R.S. 1984, as ); <br />5. As the applicant/operator, I do not have any mining/prospecxing opemtions in this state of Colorado currently in <br />violation of the provisions of the Mined Land Reclamation Act (Section 3432 -120, CRS. 1984, as amended) as determined <br />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 <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18- 8-503, CJLS 1984, as amended. <br />This form has been approved by the Mined Land Reelanra"n Board pursuant to section 34-32110,CR.&, of du Mined Land <br />Ramon Act Arty aheradon or mod#ication of this form shalt result m voiding any permit issued on the altered or mod4%d <br />form and subject the operator to cease and desist orders and evil pahaftes for operating without a permit pursuant to section <br />34-32 -123, CR.S <br />Signed and dated this / Z /nok day of l `f V � U s a ! <br />WIMAM <br />By: / <br />Title: 0et?,y Tei/L <br />State of <br />) ss. <br />County of 1 oaf 1 <br />If Corporation Attest (Seal) <br />By: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerks <br />The foregoing instrcm ent was acknowledged before me this (� day of i— DO f3 ' <br />by i rin "'I as a:6./ of <br />/ Jo Q <br />Qr- <br />SA <br />A • S otary Pubhc <br />,t�G •p T A'• ; �� My Commission expires: xDI <br />q <br />SIGN 1t 1�'BE 1�1 eft <br />9�F OF C Ot-OPP <br />