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410 <br /> -5- <br /> • <br /> 4. I understand that statements in the application are being made under penalty <br /> of perjury and that false statements made herein are punishable as. a Class 1 <br /> misdemeanor pursuant to Section 18-8-503, C.R.S. <br /> Signed and dated this , /47 day of , /47q1. <br /> kJ/61kb kiwi._ <br /> 1 <br /> Applicant/Operator If Corporation Attest (Seal ) <br /> iLBy: 111r By: <br /> Title: 1111.794.__ Qgr Corporate�Secretary or Equivalent <br /> ��"" TowiI CI-ty/C. unty Clerk <br /> State of CU ) <br /> ) 55. <br /> County ofarl c7 ) <br /> 1 <br /> The foregoingf/�, instrument was acknowledged�lbefore me this 1 'day of� Mc /got/ <br /> by A1.61v F e t u ti It as tJ.JI QQ,�(.6-1r of �ct O c�i) G� • <br /> -<ql(1/1Q <br /> CADGCallotary Public <br /> My Commission Expires: 101 zK(c/ 7 <br /> (04/92) 2823F <br /> 1111 <br />