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2016-12-08_REVISION - M1978210 (6)
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2016-12-08_REVISION - M1978210 (6)
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Last modified
6/16/2021 5:27:06 PM
Creation date
12/9/2016 2:04:41 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1978210
IBM Index Class Name
REVISION
Doc Date
12/8/2016
Doc Name
Completeness Notice
From
DRMS
To
Various
Type & Sequence
AR4
Email Name
PSH
Media Type
D
Archive
No
Tags
DRMS Re-OCR
Description:
Signifies Re-OCR Process Performed
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-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 conditions: <br /> 1. To the best of my knowledge,all significant,valuable and permanent man-made structure(s)in existence at the time <br /> this application is filed,and located within 200 feet of the proposed affected area have been identified in this application <br /> (Section 34-32.5-115(4)(e),C.R.S.). <br /> 2. No mining operation will be located on lands where such operations are prohibited by law <br /> (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 State of Colorado currently in <br /> violation of the provisions of the Colorado Land 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. 1 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 1 misdemeanor pursuant to Section 18-8-503,C.R.S. <br /> Thu form has been approved by the Mined Land Reclamation Boardpursuant to section 34-32.5-112,C.R.S.,of the Colorado Land <br /> Reclamation Act for the Extraction of Construction Materials. Any 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.SJJ. <br /> Signed and dated this�_day of <br /> UP, G POA, W _45 If Corporation Attest(Seal) <br /> Applicant/Op for or Company Name <br /> LSigned: Signed: <br /> Corporate Secretary or Equivalent <br /> Title: Q Town/City/County Clerk <br /> State of &1 d act jo ) <br /> ss. <br /> County of tie 1 <br /> The foregoing instrument was acknowledged before me this /5 rK day of a iG <br /> 090/1 ,by as Cou nay Enq�n�_ofPu JiPc, WVe_ko �tiP7' <br /> �aY.P. <br /> SHARON Notary Public <br /> BENSON . 0 5�aµ <br /> My Commission expires: /.20 <br /> 9lE©F,CO`OQP <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 />
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