2016-05-04_REVISION - M1986102 - Laserfiche WebLink

Home Browse Search

-7- Certification: As an authorized representative of the applicant,I hereby certify that the operation described has met the minimum requirements of the following terms and conditions: I. All necessary approvals from local government have been applied for(Section 34-32.5-110(1)(aXVIII). 2. To the best of my knowledge,all significant,valuable and permanent man-made structure(s)in existence at the time this application is filed, and located within 200 feet of the proposed affected area have been identified in this application (Section 34-32.5-115(4Xe),C.R.S.). (NOTE: For 110 operations,the affected area includes all lands delineated by the permit boundary.) 3. No mining operation will be located on lands where such operations are prohibited by law(Section 34-32.5-115(4)(1), C.R.S.). 4. As the applicant/operator,I do not have any mining/exploration operations in the State of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials(Section 34-32.5-120,C.R.S.). 5. I understand that statements in the application are being made under penalty of perjury and that false statements made herein are punishable as a Class l misdemeanor pursuant to Section 18-8-503,C.R.S. 1984. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32.5-110,C.R.S,of the Colorado Land Reclamation Act for the Extraction of Construction Materials.Any alteration or modification of th is form shaU result in voiding any permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section 34-32.5-123,C.RS. +h Signed and dated this day of-5e Arr , Daniel L.Collins If Corporation Attest(Seal) Applicant/Operator (( c , Signed: L-Cv Signed: ` 4 Corporate Secretary or EFalent Title: Managing Partner LytioagournaL own/City/County Clerk .1. c----Owirikaistes sit cry f Nary Palk-Ada CoIlleriespe Car* ur.Ovine of t o } y �Pommy Adana ss. County of-g�- t\JVIA( ) l The foregoing instrument was acknowledged before me this ;