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-6- <br /> Certification: <br /> As an authorized representative of the applicant,I hereby certify that the operation described has met the minimum requirements of <br /> the following terms and conditions <br /> 1. All necessary approvals from local government have been applied for(Section 34-32.5-11 l(1)(a)(LX)): <br /> ? This entire mining operation will not affect more than 30 acres: <br /> 3_ This mining operation will not adversely affect the stability of any significant.valuable and permanent man-made <br /> structure(s)located withm two hundred(200)feet of the affected lands_ (However,where there is an agreement between <br /> the applicantioperator and the persons having an interest in the structure that damage to the structure is to be compensated <br /> for by the applicant operator(Section 34-32 5-115(4)(e).CR_S 1984_as amended),then mining may occur within 200 feet_ <br /> Proof of an agreement must be submitted to the Office prior to the decision date.) <br /> 4_ No mining operation will be located on lands where such operations are prohibited by lain <br /> (Section 34-32 5-I I5(4Xf),CR S. 1984,as amended): <br /> 5_ As the applicant�operator.I do not have any mining exploration operations in thus state of Colorado currently in <br /> violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials <br /> (Section 34-325-120,CA-S. 1984-as amended)as determined through a Board finding. <br /> 6. I 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. 1984,as amended_ <br /> This form has been approved br the flitted Laud Reclamation Board pursuant to section 3,1-3_'.5-111,C.R-S.,of the Colorado <br /> Laird Reclartratioit Act for ilieExtractiort of C'onstructiorr tlaterials. Arty alteration or modification of this fornt shall result in <br /> voiding prim perinit issued on the altered or modified forin and subject the operator to cease and desist orders and civil penalties <br /> for operating n•ithoat a permitpursnant to section 34-3:.i-123,C.R.S. <br /> Signed and dated this Z day of r__Z ;,Ra—& <br /> ```su u i t n r r�rrrrr <br /> G <br /> SEMA Construction, Inc. If Corporation Attest(��eO RO <br /> Applicant'Operator _ y �9A" <br /> B- B- <br /> Vice Presider Corpo to Sech orEgtt"alert <br /> Title: Town;Citr Ggu •j'(?k �.` <br /> State of �I r a d o <br /> , �r��p�ii�s,``````` <br /> )SS. <br /> County of Areae u ,t- ) <br /> The foregoing instrument was acknowledged before ire this t Z day of t)e'hD be✓ Zo 1 a <br /> by Mark W. Pj,(wlC-s as Vtce P(tS tdcvcE- of SENf} <br /> Notary Public <br /> My Commission expires_ 1 O L`L l27 0 Z <br /> SIGtiATURES'MUST BE 11 BLUE FXIK NANCY T GUERRERO <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20124067633 <br /> MY COMMISSION EXPIRkS 1011912020 <br />