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,. <br />Certification: <br />-6- <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the m;n;m,,,,, requirements <br />of the following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.`-110(1)(a)(viii). <br />2. To the best of my ]atowledge, all signi&cant, valuable and permanent man-made structure(s) in existence at the time <br />this application is fled, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-I15(4)(e), C.RSJ. (NOTE: For 110 operations, the affected azea includes all lands delineated by the <br />permit boundan-.) <br />3. No lnuiing operation will be located on lands where slch operations are prohibit; d by law (Seedon 34-32.5-115(4)(f), <br />C.RS.). <br />4. As the applicandoperator; I do not have any miring/prospecting 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 (Section 34- <br />32.5-120, C.R.S.). <br />~. I understand that statements in the application aze being made under penalty of perjury and that false statements made <br />herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984. <br />Signed and dated this ~ day of ~-~ c700a- <br />~1 ~-„J ~hC.A KP_ <br />Applicant/Operator <br />Signed: ~~~SL <br />If Corporation Attest (Seal) <br />Signed: <br />Title:„ L1-~~~- Y~4I.~M <br />State of ~ 1 Lhrra.t~r~ ) <br />ss. <br />County of ~ U~~'-c-,1 tJ 1 <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this `-F ~ day of ~„~,.~~, ~ nn~. , by <br />` `, 1 A p n \ `~ \ ,~- <br />~~~. ~ I0.-~ as Law;l ~ AS.r . ~'` ~ c,,.'~,n ~SNit-T'la-/ of l~ n r'~I r.., L-oy-...-F~ <br />~~ -- - ~ _ o <br />- Notary Public (~ <br />My Commission expires: ~-~rf-. Z'~ DOS <br />SIGNATURES MUST BE IN BLUE INK <br />M\mm\shaze\vsfmms\Cmy,uc4ion110 (10/15/2001) <br />