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'' <br />- 6 - <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation <br />described has met the minimum requirements of the .following terms and conditions: <br />1. All necessary approvals from local government have been applied for <br />(Section 39-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application is filed, and located within 200 <br />feet of the proposed affected area have been identified in this application (Section 39- <br />32.5-115(9)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands <br />delineated by the permit boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by <br />law (Section 34-32.5-115(4)(f), C.R.S.). <br />9. As the applicant/operator, I do not have any mining/prospecting operations in the <br />State of Colorado currently in violation of the provisions of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials (Section 39-32.5-120, <br />C.R.S.). <br />5. I understand that statements in the application are being made under penalty of <br />perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S 1989. <br />Signed and dated this day of , <br />If Corporation Attest (Seal) <br />Appli nt/Operator <br />Signed: ~ Signed: <br />Title: <br />State of C o%r a cC o ) <br />~ ss <br />County of L~G~~-e-e-- ) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this~~~ day of ~ o~.ar <br />~'os~P~ Gayah --y-- <br />by 1`~~~-~h•t ClJrnn as ~/rINwKS of o r/ <br />SPN~OVq~ O ~ ~ <br />My <br />SIC.R~UITURE3 MAST HE IN <br />~r Notary,g lic <br />Z V. c <br />j.on expires, ~ <br />~~ <br />04/25/97 2821FC0.110 <br />