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0 • RECEIVED <br />-�- NOV 0 7 1996 <br />certificatioul <br />Division of Minerals b (30010gy <br />As an authorized representative of the applicant, x hereby certify that the operation <br />described has met the minimum requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application is filed, and located within 200 <br />feet of the proposed affected area have been identified in this application (Section 34- <br />32.5-115(4)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by <br />law (Section 34-32.5-115(4)(f), C.R.S.1 <br />3. As the applicant/operator, i do not have any extraction/exploration operations in the <br />State of Colorado currently in violation of the provisions of the Colorado Land <br />Reclamation Act for the Nxtraction of Construction materials (Section 34-32.5-120, C.R.S.) <br />as determined through a Board finding. <br />-4. 3 understand that statemerits'0--the-application are being made under penalty of <br />perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this Zq day of S2 b."— <br />Applicant/operator <br />Signed$ �7q '- <br />Titles <br />State of c�jo-'�`� ) <br />) s$ <br />County ofo�vr�ez �� ) <br />if corporation Attest (Seal) <br />Signedt <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument trete ac.twowledged. before me this day of <br />by `fin. iUl�e�x.p, , , ms �d�L3'r.r �2� - - Of M�7tL�c2U-tttiezCOU rL�+., <br />Lj.i�.Lo` <br />Notary Public <br />my Commission expires: � �� � Awr <br />01/b!/96 ?823PC0.1i2 „ <br />.' <br />m <br />