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FROM :LISPS YODER CO 80864 FRX N0. :7194783161 Rpr. 01 2005 02:10PM P3 <br />Certification: <br />-6- <br />As an authorized representative of the applicant, I hereby certify that the operation desaibodhas met tbeminiNnttnr~ogtmements of <br />the following terms and conditions: <br />All Necessary approvals from local government have boon applied for (Section 34-32.5-110(1)(a)(VIII). <br />2. To the best of my knowledge, allsignificant, valuabh;end pemtanentman-made shucture(s) iaex~stmce atUx time this <br />application is filed, and located within 200 Beet of the proposed affected area have baea identified in this application <br />(Section 34-32.5-I15(4)(e), C.RS.). (NOTE: Fair 110 operations, the affected area includes all lands delineated by the <br />Permit boundary.) <br />3. No mining operationwillbe located on lands where such operations are.prolubited by law (Section 34-32.4-115(4Xt), <br />C.RSJ. <br />4. As the applicant/operator, l do not have any m~ting/exploration operations in the State of Colorado ciurentty is <br />violation of the previsions of the Cohaado Land Reclamation Aa for the Exhsaion of ConsCUCtioa Materials <br />(Section 3432.5-120, C.RS.). <br />5. l understand that statements in the application are being made under penalty ofperjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant td Section 18-8-503, C.R5.1984. <br />This forerhas been approved by t1reMasedCmtdReci'anrationBoardpnrsamrt toseaiasa3¢32SIIO,C'.RS, ~theColorada <br />LandReclanrationActfortheEaQractio»ofConstrucYioaitfateriaLc Anyaltaationormo~JicationofBFiajorneshaUrrsak <br />in voiding any per-nit isaaed on the altwed or nsodijaed form and sabjed the operaeor to cease and desist orders mad civil <br />penalties jar operating withoat a pomil pwsaant to section 34-37,-123, C.RS <br />Signed and dated this ~_ day of T,g ~ ~~~ <br />r <br />Apphcant/t7perator D /~ <br />SignedC~ -~G~ s~-lX-r~ <br />If CorporatioN Attest (seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Title: ~~2`.t mil/ <br />State of WlJ1~w~~o <br />County of ~t1.Qa5~ 1 ss. <br />TowrJCsty/County Cleric <br />The foregoing instnancart was aclmowledged before me this ~_ day of ~.n~h O~ S <br />by w~ e. ci e~e~r as taw ~, e ~ ,.,._ of Sr~~ w. C~,..r.~-r~,c-~n. <br />Notary Public <br />". My Coaurtission esP;res: _L 1. L •t~ln <br />SIGNATURES MUST BE IN BLUE INK <br />