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b - <br />Certification: <br />As an authorized representative of the applicant. I hereby certify that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />All necessary' approvals from local government have been applied for (Section 34-32.5-110(l)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-1 l5(4)(e), C.R.S.). (NOTE: For ILO operations, the affected azea includes all lands delineated b_v the permit <br />boundary.) <br />3. No mining operation will be located on lands where such operations aze prohibited by law (Section 34-32.5-1 l5(4)(f), C.RS.). <br />4. As the applicant/operator, I do not have any mining/prospecting operations in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Conswction Materials (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements in the application are being made under penalty of perjury and that false statements made herein <br />aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS 1984. <br />Signed and dated this ,(~!Y~ lv(.~l day of /l~(lJtt y .a~U~~~ <br />n ^ G' n <br />tiXti~(~ .~I~P~ I~~~I~',e~//~Y~~fr1 <br />ApplicandCtperator <br />Signed: ~~l~C, C-L.C'~~ ~~~ 5~~(f <br />Title: <br />State of Co1o2ac~o ) <br />ss. <br />County of ~-~ nc o ~ n ) <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this U~l-h day of hFoR-e~ aooa , by <br />~~d, l C_ . ~ r'~'i l ~ i c ~ ~ ~~ ~ as of <br />_~ <br />Notary Public <br />My Commission expires: ,`'%1=h9-aoo7 <br />SIGNATURES MUST BE IN BLUE INK <br />M:VNIN\SEL4RE\VSFORMS\2821COIO.APP 062ii99 <br />