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<br />-~- <br />Certificatioa: <br /> <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. To the best of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at [he 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.). <br />2. 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 />3. As the applicant/operator, I do not have any extraction/exploration 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, C.R.S.) <br />as determined through a Board finding. <br />4. 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. <br />Signed and dated this ~~ day of J <br />~l Ohm s o .,, l--`f- ~''~ ~ .t, - ... _ - <br />If Corporation Attest FSe`al) - - - -- _ <br />Applicant/Oper for or C pany Name <br />~-. - <br />Signed: Signed: /~ <br />(\\~ Corporate S cretary or Equivalent <br />Title: ~ C~ Town/City/County Clerk <br />State of Colorado ) <br />ss <br />County of Routt ) <br />The foregoing instrument was acknowledged before me this 17th day of June 1998 , <br />by Charles D. Johnson as President of Johnson Excavation, Inc. <br />No ary'Public <br />- = My Commission expires: 11/22/99 <br />n' . <br />- - ~ SIGNATIIRES MAST BE IN BLIIE INK <br />06/26/97 2823 PCO.11Z <br />