Laserfiche WebLink
- 8 - <br /> 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 condition,: <br /> 1. I o the best of my know ledge.all significant.`aluahle and permanent man-made structure(s)in existence at the time <br /> this application is filed,and located ss ithin 200 feet of the proposed affected area have been identified in this application <br /> (Section 34-32.5-I l5(4)(e).('.R.S.). <br /> 2. No mining operation will he located on lands where such operations are prohibited by law <br /> (Section 34-32.5-115(4)01 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 pros isions of the Colorado I and 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 I misdemeanor pursuant to Section I8-8-503. C.R.S <br /> This form has been approved hr the Mined Land Reclamation Board pursuant to section 34-32.5-112,C.R.S.,oldie Colorado Land <br /> Reclamation Ortfir the Extraction of Construction Materials. /lily 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 '2 a day of /- F t3 2 RGI 2.0 0:7 <br /> b <br /> sbct i ' C kcc Co ni-rQ,A1 5 a INC . If Corporation Attest(Seal) <br /> Applicant/Operator or Corn < •y Name <br /> 1111 <br /> Signed: -^^ � Signed: <br /> Corporate Secretary or Equivalent <br /> Title: Vice President Town/City/County Clerk <br /> State of e."-JQAv7 <br /> r ss. <br /> County of /t� t' 1 ' <br /> The foregoing instrument was acknow ledged before me this( =-r day die\OfcloY <br /> gaG by e. - 'K \—Xvti`.Y\ as Ukce. \evtj- of\ dj�ezYce. <614. <br /> JULIE WALLER <br /> NOTARY PUBLIC 7 ry Public <br /> STATE OF COLORADO <br /> NOTARY ID 20144039814 <br /> MY COMMISSION EXPIRES 10/1W2018 1s Commission expires: <br /> SIGNATURES 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 />