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. 7 - <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man -made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34- 32.5- 115(4)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section 34- 32.5 - 115(4)(0, <br />C.R.S.; <br />3. As the applicant/operator, I do not have any extraction/exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34- 32.5 -120, C.R.S.) as determined through a Board finding. <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 1 misdemeanor pursuant to Section 18 -8 -503, C.R.S. <br />Signed and date$ this day of <br />6C A, It n q 50-V `F 61 : -A 4 (�- 6 <br />Applicant/Operator or Company Name <br />Signed. <br />Title: <br />State of ,at \l LAt <br />) ss <br />C of 'k <br />Signed: <br />If Corporation Attest (Seal) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The fgregoing ' trument was aclmo lodged before me this day o �� V <br />bye= -1 �.4 iM0.,r ? as �� aM �7►'t�/ of CL Q <br />Wo <br />Notary Publico - ©`O <br />My Commission <br />SIGNATURES MUST BE IN BLUE INK <br />CP W -'-� <br />