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III <br /> M-2001-001 Line Camp Pit Amendment#2 (Expansion) <br /> 5 - <br /> Certification: <br /> As an authorized representative of the applicant. I hereby certify that the operation described has met the mminnsm <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 tune <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.RS.). <br /> 2. No twrung operation will be located on lands vitae such operations are prohibited by law <br /> (Section 34-32.5-115(4Xf).C.RS.. <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 I misdemeanor pursuant to Section 1S-S-503.C.R.S. <br /> This form has been apprased by the-Vined Land Reclamation Board punuanr to section 34-32.5-112,C.R.S..of the Colorado Land <br /> Reclamanoz.Act for the Extraction of Construction.tlettlrelt, eitly alteration or Modification of this fonts shall result in voiding any <br /> permit issued on the ahered or modified farad and subject the operator to cease end drsist orders and civil penalnes for operating <br /> without a permit pursuant ro section 34-32.3-1:3,C.RS. <br /> Sinned and dated this 15th day of November , 2024 <br /> Smith's Materials, LLC If Corporation Attest(Seal) <br /> Appicant/Operator or Comoanv Name <br /> Signed: Na an A. Barton,CE.PE. PEE Signed. <br /> Authorized Agent and Corporate Secretary or Equivalent <br /> Title. Envkonmerstal and Pemitting Comptionoe Engirwret TowniCuty/Cournty Clerk <br /> State of South Dakota <br /> )ss. <br /> County of, Pennington „) <br /> The foregoing instrument was acknowledged before me this 15th day of November 2024 <br /> tiNathan A, Barton as Authorized Agent of Smith's Materials, LLC. <br /> a+taaaa.a+.a.a...aaa+aaaas+rrsaf <br /> OE BORAH A BARTON F r �....i .-1 _ <br /> NOTARY PUBLIC Notary Public Deborah A. Barton <br /> _ STATE Of SOUTH DAKOTA t.t5 <br /> _ <br /> 1fy Cormnmssion expires:12 December 2025 <br /> SIGNATURES MUST BE LN BLUE INK <br /> 5182-22-001 WASTELINE, INC. Page 9 of 65 <br />