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C~ <br />-~- <br />Certification: <br />ss. <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.5-1 10(l)(a)(viii). <br />2. To the best of my Imowledge, all significant, valuable and permanent man-made structure(s) m existence at the time <br />this application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.E-1 l~(4)(e), C.RS.). (NOTE: For 110 operations, the affected azea includes all lands delineated by the <br />permit boundary) <br />3. No ruining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-I l~(4)(f), <br />C.RS.). <br />4. As the applicant/operator, I do not have any mining/prospecting operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Ad for the Extraction of Construction Materials (Section 34- <br />325-120, C.RS.). <br />~. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. <br />Signed and dated this 27 day Of Novembe r <br />Todd Dysart <br />ApplicannnUOp~~erator <br />Signed: .~~1~/~ ~~_ <br />Title: Applicant <br />State of Colorado <br />COUnty Of ~ Logan <br />The to~egoing instrument was acknowledged before me this <br />Todd Dysart as N.A. <br />2000 <br />Signed: <br />27 day of _ <br />of <br />• <br />If Corporation Attest (Seal) <br />N.A. <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />November <br />N.A. <br />2000 by <br />// <br />~, t <br />i <br />Not Publi <br />My Commission expires: 06=23-01 <br />SIGNATURES MUST BE IN BLUE INK <br />