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 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. ff <br /> Signed and dated this day of &h l 20 2�3 <br /> LeW S Cn cry y L o-ne4j.<l.-.C If Corporation Attest(Seal) <br /> Applicant/Operato or Company me <br /> Signed: Signed: <br /> `' Corporate Secretary or Equivalent <br /> V Title: Ge 1;,-tJe, Town/City/County Clerk <br /> State of 2wC ) <br /> )ss. <br /> County of_Bat( V�n <br /> ) <br /> The foregoing inst ent was acknowledged before me this day of h <br /> by � �l �� as a of , <br /> 1 - <br /> t. Cristina Moncivais <br /> (* ` My Commission 5/7/2024 Expires Notary ubhc <br /> 1 Notary ID <br /> 132468275 <br /> My Commission expires: 5�IbY <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 />