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~~ <br />Certification: <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 34- <br />32.5-115(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands <br />delineated by the permit boundary.) <br /> <br />- 6 - <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. A11 necessary approvals from local government have been applied for <br />(Section 34-32.5-110(1)(a)(viii). <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 />4. As the applicant/operator, 2 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 34-32.5-120, <br />C.R.S.). <br />5. 2 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 1984. <br /> <br />Signed and dated this ~ day of JAN ~C l~. <br />~"TT~ ~-~CGAJ~4-r)n <br />Appl~;i/c~ant /Ope~or <br />Title: `~~-l%~,~ <br />State of I,r~G~) <br />G/~~ ) ss <br />County of ~~~~) <br />The <br />by <br />If Corporation Attest (Seal) <br />Signed: ~,(/ s~~~ -• ~~-/~% <br />Corporap Secretary or Equivalent <br />T//own/City/County Clerk <br />foregoing instrument was acknowledged befgqor~~e me this ~ day of ~JQ ~ ~, <br />as ~ I ~H~ f 7LYGL~ °f ~~~r (~ Q~ ~(,l~r~{~L <br />1(.~~~.~ 6~.- I~~~~fa~ <br />~ Notary P`u llc hh <br />My Commission expires: t ~ o f V <br />SIGNATURES MUST BE IN SLUE INK <br />04/25/97 2821FC0.110 <br />