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7. <br /> Cer'tificxtiop: <br /> As an authoritcci mprescntalwc of the applicant.)hereby ccnlif,that the operation described has met the nunimum requiremcrim of the <br /> following terins and conditions: <br /> I. All necessary approvals from local government have been applied for(Section 34-32.5-1 RX t xa)(Vlll). <br /> 2. To the best of my knowledge.all significant.valuable and pernvuenl mart-nwde structurc(s)in existence at ilk:tithe this <br /> application is filed, and located within 21M) feet of tlx: proposed affected area lune been identified in this application <br /> (Section 34-32.5-115(4)(e).C.R.S.). (NOTE. For I Ill operdtions,the affected area includes all lands delimited by tlx:pernut <br /> boundan.) <br /> 3. No nanung operation trill 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 toot have any mining/explomlion opcmlions in the State of Colorado cumittly in violation of <br /> the provisions of the Colorado Land Reclarm ion Act for tle E:xtractionofConstruction Materials(Section 34-32.5-124),C.R.S.). <br /> 5, 1 understand that statements in to application are being rack:wrier penalty of perjury and that false statemems inadc hereon <br /> arc punishable as a Class I misdcmcanor pursuant to Section 18-8-503,C.R.S. 1994. <br /> This form hav helm approved b►'the Mined Lund Reclamation Roard pursuant to wtWon 34-3:S-!1 U,(:K 1.,ojthe Colorado Lanni <br /> Reclamation Ad jor the b:Klraelirm of(.is wutlion Materiak. An►-alteration or modifitwitm of shk form steal!nib in vokhng wtv <br /> permit iswed on the altered or modified form and subject the t1wrator to cease and devivt orders and civil penst1d s for operating <br /> ►vithiwt it permit pursuant to wttion 3.1-32.5-11,t,C.&ti. <br /> Sigiv.d ate)dated thus - LZ 4k day of Ap r: 2022 <br /> South Hinsdale Sand & Gravel LLC If Corporation Attest(Seal) <br /> Appticani/fxcrator <br /> Signed: �'�-- — Signed: <br /> Corporate Sccrctan•or Equivalent <br /> Title: Manager,South Hinsdale Sand&Gravel LLC Town/City/County Cleric <br /> Static of �Y' <br /> County of nn <br /> The foregoing inctrumcnt nas acknowledged before rmc this day of t�p 2022 <br /> by Travis S Texer ---as Meer of.South_Hirlsdale_Sand&_.-- <br /> � Gravel, LLC <br /> A notary public or other ootay complelinp the si <br /> certificate vorifies only the Identity of the Notary Public <br /> individual who a*"the doeernant to which Nis <br /> undkale Is&#$Chad.and no the trulhf woess. My Commission expires: 3- `L-3 <br /> accuracy, or validity of that document. <br /> SIGNATURES MUST BE IN BLUE INK <br /> DANIEL ELI SVtURTN <br /> Comm.No 22789f33 r <br /> f ^ NO "!�FK,IaEiC•CAW,;i2S,lA y <br /> tG s '4j� i ja SLAW,C_Ut+tti <br /> � � ErasUx*t75 r7i3 <br />