Laserfiche WebLink
- 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 fording. <br /> 4. 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. <br /> This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32.5-112,GR.S.,of the Colorado Land <br /> Reclamation Act for the Extraction of Construction Materialk 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 19, day of Q Duevin Low , <br /> Aggregate Industries, WCR Inc. <br /> If Corporation Attest(Seal) <br /> Applicant/Operator or C Name <br /> Signed. Signed: <br /> Corporate Secretary or Equivalent <br /> Title:�d{1 jMcD (-'3k "a(-6_D YY�QY)Q Town/City/County Clerk <br /> State of C0_ a6.0 ) <br /> ,�.. )ss. <br /> County of J�-&C Y 5u1n ) <br /> The foregoing instrument was acknowledged before me this IQ day of NOuern La <br /> )DA,by d.n CM(!!a as RViumed (-Pnoj11P wrda of 'o <br /> SAW OREGA L) x, a4N <br /> J�� <br /> gTA�AROoIB 0 Notary Public <br /> NOTARY D 20174007157 <br /> MY COMMMSUM EXPM FEBRUARY 21.202I <br /> My Commission expires: IDL d 1( <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 />