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-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 finding. <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,C.RS.,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 modifted 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 IS day of Al ti y e m ber 2- <br /> Q,2.2 <br /> A Sop c 1+i e.c C o. If Corporaatt' <br /> Applicant/Operator or Company Name �y <br /> Signe <br /> Co tes ecre A r Equivale <br /> Title: President 1 9V9V C' /County Clerk <br /> State of �L c c J <br /> )ss. <br /> County of^Aa{aws ) <br /> The foregoing instrument was acknowledged before me this 1 `zf? day of <br /> by <br /> } as 19ke 5 6"e + <br /> 1 � ; <br /> JAN NELSON <br /> NOTARY PUBLIC Notary Public <br /> STATE OF COLORADO <br /> NOTARY ID 199%030527 <br /> My Cow nWelon Expime April 29,2024 My Commission expires:fj►4, ''t� :�c r t; <br />