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2019-08-09_PERMIT FILE - M2019044
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2019-08-09_PERMIT FILE - M2019044
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Last modified
12/27/2024 11:31:19 AM
Creation date
8/9/2019 3:35:05 PM
Metadata
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Template:
DRMS Permit Index
Permit No
M2019044
IBM Index Class Name
Permit File
Doc Date
8/9/2019
Doc Name
Application
From
Blattner Energy, Inc.
To
DRMS
Email Name
TC1
MAC
Media Type
D
Archive
No
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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 /> I. All necessary approvals from local government have been applied for(Section 34-32.5-110(1)(a)(VI11). <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)(0, <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. I 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 I misdemeanor pursuant to Section 18-8-503,C.R.S. 1984. <br /> This form has been approved by the Mined Land Reclamation Board pursuant to section 34-3Z 5-11©,C.R.S.,of the Colorado Land <br /> Reclamation Actfor the Extraction of Construction Materials. Any alteration or modification of thisform 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 :7 day of q <br /> BCf� o If Corporation Attest(Seal) <br /> Applicant/Operator <br /> Signed: Signed: <br /> Corporate Secretary or Equivalent <br /> Title:( geld GUrI$�'1'LtL!• 6ordowmAo " Town/City/County Clerk <br /> State of C 1( J f3 ) <br /> ss. <br /> County of �",QAt,,e <br /> The foregoing instrument was acknowledged before me this day o_fI r�v <br /> by (.O� S�alrer as �o� a �iof��+a LC71�C <br /> PATRICIA A DAUGHERTY <br /> NOTARY PUBLIC Notary Public <br /> STATE OF COLORADO <br /> NOTARY ID 201540007448 M Commission expires: Feb i �l , <br /> I MY COMMISSION EXPIRES FEB 20,2023 y p <br /> SIGNATURES MUST BE IN BLUE INK <br />
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