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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 /> 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 lards 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 <br /> WESTERN MOBILE SOUTHERN INC. <br /> a subsidiary of Lafarge Corp. If Corporation Attest (Seal), <br /> Applicant/Operator or Company Name <br /> Signed: Signed: <br /> STE HEN J BURNSIDE rporate Sec etary or Equivalent <br /> Title: Asphalt/Aggregate Business Unit Manager Town/City/County Clerk <br /> State of <br /> ) ss <br /> County of ) <br /> The foregoing instrument was acknowledged before me this day of <br /> by as r k� of <br /> 7MARGAARET F.CASTLEBERRY Notary Publicry Public <br /> t Colorado My Commission expires: <br /> SIGHATURES MUST BE IN BLUE INK <br /> 04/25/97 2823FC0.112 <br />