Laserfiche WebLink
-~- <br />Certlflcation: <br />As an authorized representative of the applicant, I hereby certify that the opemtion described has met the minimum requirements of the <br />following terms and conditions: <br />1. All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(a)(VII[). <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 34-32.5-115(4xe), C.RS.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit <br />boundary.) <br />3. No mining operation will be located on (ands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.R.S.). <br />4. As the applicanUoperatoy I donot haveany mining/exploration operations in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extmcdon of Construction Materials (Section 34-32.5-120, C.RS.). <br />5. I understand that statements in the application are being made under penalty of perjury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984. <br />This jarm has bern approvedby theMhred Land Reclaanatian Board pursuant to section 34-325-IIO,CR.S> ojtheColorado Land <br />RtclarnvNonActjortheExtiadlonojConetrucdonMaferlaLc ArryaBndbnormadnofthirjonrrshoUresu/tlnvoidingmty <br />permit Lssued on the altered or modified form and subJect the operator to cease and desist orders and civil prnalties jor operating <br />withou(a perrrdt pursuant to section 34-32..L123, GRS. <br />Si tg~ned and da~~te/~dJ/this ___-~ ___ day of <br />.~[A/pplic`anUOpera/tort / <br />signed: ~u~~~- GA/ti~'^- <br />Title: ~in.~~7.,vjf <br />2 00 (o <br />If Corporation Attest (Seal) <br />sign_ :.~ ~ .. ~ ~.[ b XY~ <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of 1..O16Q R.a~O ) <br />ss. <br />Covnh• of LEl_TA ) <br />The foregoing instrvtttem was acknowledged before me this ~n(_~ day of <br />d4~,b}' ~la..rt GJL~~S dn~ Ltlltean I.t)~))S as YYCS~¢r\t'- and ~rcre.~tv., of <br />Q,~,A~t~r~Gta.t~{ , Inc . <br />O~~Y~P~`~~i <br />?: ~ .~(r Notary Public <br />~~ ~ i ~ M}• Commission expires: ~O " ~ ~ - V b <br />1AIELLS <br />BLUE INK <br />M:\minlsture\vsfornslCOOSwcaonll0 (Approved 05/I <br />