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2014-04-04_REVISION - M1977522
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2014-04-04_REVISION - M1977522
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Last modified
6/15/2021 3:13:13 PM
Creation date
4/8/2014 9:16:50 AM
Metadata
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Template:
DRMS Permit Index
Permit No
M1977522
IBM Index Class Name
REVISION
Doc Date
4/4/2014
Doc Name
Notices AM02
From
DRMS
To
Various
Type & Sequence
AM2
Email Name
ECS
Media Type
D
Archive
No
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Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements 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 <br />this 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 <br />(Section 34- 32.5- 115(4)(f), 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 <br />(Section 34- 32.5 -120, C.R.S.) as determined through a Board finding. <br />4. 1 understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18 -8 -503, C.R.S. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34- 32.5- 112,C.R.S., of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this form shall result in voiding any <br />permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties for operating <br />without a permit pursuant to section 34- 32.5 -123, C.R.S. <br />Signed and dated this day of <br />L.G. Everist, Incorporated <br />Applicant/Operator or Company Name <br />Title: Vice President <br />State of <br />ss. <br />County of <br />Attest (Seal) <br />i <br />Corporate Secretary or Equivalent <br />Town/City /County Clerk <br />The foregoing instrument was acknowledged before me this day of21� , <br />67-6�`14, by Dennis L. Fields as Vice President of L.G. Everist, Incorporated <br />?TR�� No( Public <br />v' NOTAR Y <br />4W- <br />SIGNATURES Commission expires: <br />PUBL�G; <br />SIGNATURES MUST BE IN BLUE INK <br />
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