Laserfiche WebLink
• <br /> -7- <br /> Certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> described has met the minimum requirements of the following terms and conditions: <br /> I. 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.; <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 Extraction of Construction Materials (Section 34-32.5-120, C.R.S. ) <br /> as determined through a Board finding. <br /> 4. I understand that statements in 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 day of *r-C_ 1 <br /> Staker _-.Vin -Construction Co. , Inc. <br /> dba Co Daring�p nstruction Co. <br /> _ If Corporation Attest (Seal) <br /> Applicant/OF5_e.rator or om Name 1 <br /> Signed: Signed: <br /> Corporate SeCrsta_ gwivalent <br /> 7l._.A.. J .. �- <br /> Title: �'��"'�" C/�R/21Y1A1� Town/Cit.v/CCunt-.-Clark <br /> State of ( °OLdeADO } <br /> Ss <br /> County of ZA P1-►3Zfi ) <br /> The foregoing instrument was acknowledged before me this 1 <br /> 6" day of <br /> by LZQn a!d f (CM a' e as of s& ! u!/U6 I <br /> :r�pTARy._ <br /> VBLIri o Notary Public -1�5 <br /> 0"COV, My Commission expires: "S dv00 <br /> SIGNATURES MUST BE IN BLUE INK <br /> 01/02/96 2MFCO.112 <br /> _ _ I <br />