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7 <br /> Crr Llficatiow <br /> As an authorized representative of the applicant,I hereby certify that h the operation described has met the rni nin'111 in requirements.rement.s of the <br /> following terms and condition,;: . <br /> I All necessan,approvals from local government have been applied for(Section 34-315-11 0(l)(a)(VIII), <br /> 2 To the best of my knom,ledge, all significant,valuable and permanent man-irrade structure(s)it,existence a, the nine this <br /> application is filed, and located within 1100 feet of the proposed affected area have been identified in this application <br /> (Section 34-32 5-1 15(4)(e),C,R.S.), (NOTE: For 11 10 operations,the affected area includes all land,;delineated by the permit <br /> boundary,,) <br /> 3 No 1-11111ing operation will be located on lands where Such operations are prohibited by law(Section 34-32_5-1 I <br /> C-R,S.). <br /> 4, As the applicant I/Operator,I do not have any ininingilexploration operations in the State of Colorado curre, yinviolationo,,' <br /> Colorado Land ReclanmTioii Act for the Extraction of Construction Materials(Section 14.32'5-120',C,R S.I. <br /> the provisions of the(oloi nt� <br /> 5. 1 understand that Statements in the application are being made under penalty of perjury and that f,"[Se statements made herein <br /> rIre punishable as a Class I misdemeanot Pursuant to Section 18-8-50,C R_Sl' 1984, <br /> This loan has been approved b'i,the MinedLand Rechititation Boardpurs�uaizi if)sectit)1134-32.5-110,C R_V.,oj*ihe Colorado!_airs! <br /> Reclamatiott A c1lbr the EIrtrai liem Any alteration or modification of thisforn;shall result in voiding an), <br /> permit issued on the altered or modifted form and subject the operator to cease and desist orders and civil penaltiesJor operating <br /> Signed and dated this lav of <br /> ---------- <br /> Y T <br /> J­ <br /> J <br /> ------ If CO"Poranon Atres,,(Sea!I <br /> Applicant Operator <br /> Signed <br /> Signed: <br /> T Corporate Secretary or Equivalent <br /> 'Fown/Oty/Countv <br /> Sta tc 1)f C, <br /> The foregoing inctrmnent was acknowledged before me this j, <br /> da,v of <br /> bv ------ <br /> )b t I Ire <br /> otary Public _ <br /> MY Commission expires <br /> jo TAR <br /> SIGNA I 1,kFS Nlus,r BE IN BLUE INK <br /> 0 CO <br /> A <br />