Laserfiche WebLink
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. I 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 thisform shall result in voiding any <br /> pernk 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.S-123,C.R.S. <br /> �7 <br /> Signed and dated this day of T,4 0 0A � G 0�D <br /> 1.o%rw.d. 51-oNc— Qom.,,,2 , y C. If Corporation Attest(Seal) <br /> Applicant/Operator o omp� Nm �'t <br /> Signed Signed: _.-- <br /> Corporate Secretary or Equivalent <br /> Tide: Town/City/County Clerk <br /> State of C o l o y-c'A 6 ) <br /> d )ss. <br /> County of {��, ) <br /> The foregoing instrument was acknowledged before me this day of Januaxw <br /> .ZOU by Tjne V?_ '��as of <br /> C� t'rit'S <br /> KIJRES <br /> IA Public <br /> ic <br /> do <br /> No51013 My Commission expires:% ��', <br /> My Commec.22,,2018 '— <br /> I RES MUST BE IN BLUE INK <br /> You must post sufficient Notices at the location of the proposed mine site to clearly identify the site as the location of a <br />