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2023-01-13_PERMIT FILE - M2022034 (2)
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2023-01-13_PERMIT FILE - M2022034 (2)
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Last modified
2/2/2023 8:31:51 PM
Creation date
2/2/2023 9:19:42 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2022034
IBM Index Class Name
Permit File
Doc Date
1/13/2023
Doc Name
Adequacy Review
From
Baseline
To
DRMS
Email Name
PSH
JLE
Media Type
D
Archive
No
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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)(0, 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.R.S.,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 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 _day of J cAmj <br /> A�wk.a\\ or C'y`O\n LJLL- If Corporation Attest(Sea E C E I V E D <br /> Applicant/Operator or Company N e WELD COUNTY <br /> JAN 13 2023 <br /> Signed: signed: COMMISSIONERS <br /> Corporate Secretary or Equivalent <br /> Title: �G.TcV�C,r Town/City/County Clerk <br /> State of <br /> ss. <br /> County of �J QA ) <br /> �h Stt11CLnn Gcc Li <br /> The foregoin 'nstntme was acknowledged before me�hliis day of <br /> by �a\ G 1\ as htr of jc'Qwk k\ G"c <br /> CARY R. IRVIN Notary P lic <br /> NOTARY PUBLIC-STATE OF CO]2025 <br /> NOTARY ID 2017400121 •�� �a <br /> MY COMMISSION EXPIRES MAR My Commission expires: <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 />
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