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 structurc(s)in existence at the time <br /> this application is filed,and located within 200 feet of the proposed affected arca 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 arc 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 arc being made under penalty of perjury and that false statements <br /> made herein arc punishable as a Class I 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 p`t t'l*tl'r4rporating <br /> without a permit pursuant to s etion 34-32.5-123, C: '..5. �` GAm. I, <br /> Q4(4)+6%� J��•...No 0 �I <br /> Signed and dated this day of �0:• TME •�',� i <br /> • <br /> • <br /> •• <br /> Connell Resources • <br /> 11i If Corporation Attc�t kl � ;e <br /> � • � <br /> Applicant/Oper or or Co pany Name ,j•\.• <br /> GO NN <br /> IPP <br /> Signed: Signed: _.se=ta I <br /> Corporate Secretary or Equivalent <br /> Title: P-r Sr d7F Town/City/County Clerk <br /> State of 1:01.,Draao <br /> LOr AK ) ss. <br /> County of <br /> The oregoinjO \ <br /> in trument was acknowledged before me j'sday of ..)L,re , <br /> by lv I Y\�a� l I as AVE �� of fl LI.• u.Y\ , . <br /> Jt <br /> JENNIFER LINDBLAD <br /> Notary Public Notary Public <br /> State of Colorado <br /> Notary ID#20144008302 Q�a1 <br /> My Commission Expires 02-21-2026 My Commission expires: l <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 />