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2018-01-05_PERMIT FILE - M2017021
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2018-01-05_PERMIT FILE - M2017021
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Last modified
1/13/2021 7:48:30 AM
Creation date
1/5/2018 4:31:28 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2017021
IBM Index Class Name
Permit File
Doc Date
1/5/2018
Doc Name
Incompleteness Response
From
Bill Schenerlein
To
DRMS
Email Name
PSH
WHE
Media Type
D
Archive
No
Tags
DRMS Re-OCR
Description:
Signifies Re-OCR Process Performed
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-7- <br /> Certification: <br /> As an authorized representative of the applicant,I hereby certify that the operation described has met the minimum requirements of the <br /> following terms and conditions: <br /> 1. All necessary approvals from local government have been applied for(Section 34-32.5-110(1)(a)(VIII). <br /> 2. To the best of my knowledge,all significant,valuable and permanent man-made structure(s)in existence at the time this <br /> 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.). (NOTE: For 110 operations,the affected area includes all lands delineated by the permit <br /> boundary.) <br /> 3. No mining operation will be located on lands where such operations are prohibited by law(Section 34-32.5-115(4)(f), <br /> C.R.S.). <br /> 4. As the applicant/operator,I do not have any mining/exploration operations in the State of Colorado currently in violation of <br /> the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials(Section 34-32.5-120,C.R.S.). <br /> 5. 1 understand that statements in the application are being made under penalty of perjury and that false statements made herein <br /> are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503,C.R.S. 1984. <br /> This form has been approved by the Mined Land Reclamation Boardpursuant to section 34-32.5-110,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.S. <br /> Signed and dated this day ofGf�r'ir v <br /> Serfer Land Ventures, LLC. If Corporation Attest(Seal) <br /> Applfcantl erator <br /> Signed: _ Signed: <br /> Corporate Secretary or Equivalent <br /> Title: Town/City/County Clerk <br /> State of 6L-ep-yr-n ) <br /> / ss. <br /> County of �/Zl ttz L ) <br /> The f regoing instrument was acknowledged before me this day of <br /> by ef—lIS S � +c_ as 4v et—' / of f" 1d <br /> CORY URBAN <br /> NOTARY PUBLIC <br /> STATE OF COLORADO ark P bli Q <br /> NOTARY ID 2WW2M C mmission expires: <br /> MY COMMISSION EXPIRES AUGUST 15 2020 <br /> SIGNATURES MUST BE IN BLUE INK <br />
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