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C rti canon: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirernents of <br />the following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 34- 32.5- 110(l)(a)(viii). <br />2. 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.). (NOTE: For 110 operations, the affected area includes all lands delineated by the <br />vemrii tanderyJ <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34- 32.5- 115(4)(f), <br />C.R.S.). <br />4. As the applicantloperator, I do not have any mining/prospecting operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Constriction Materials <br />(Section 34- 32.5 -120, C.R.S.). <br />5. 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, CKS. 1984. <br />Signed and dated this day of � DD <br />State of e0l. e, to 6 ) <br />ss. <br />County of �l % Pr2� } <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />TowWCity/County Clerk <br />The foregoing instrument was acknowledged before me this day of sP��f� ��2 ,�e�� by <br />�l F004 Y-r JL� / �2as f Aft /dlC�l��7�� of -5-cA f2 A Chi+ <br />otary Public <br />My Commission expires: ell <br />SIGNATURES MUST BE IN BLUE INK <br />M:Vnin\sh=\vsfor=T-o=Uuction110 (05/06=03) <br />