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-~- <br />Certification: <br />As ao authorized representative of the applicant, I hereby certify that the operation describedhas metthe minimum regtm~ts of <br />the following terms and conditions: <br />1. To the best ofmy knowledge, all significant, vafiableand permancetman-maw struchne(s) in erdstence at the time this <br />application is filed, and located within 200 feet of the proposed affectod area have been identified in this applicatcn <br />(Section 3432.5-115(4)(e), C.RS.). <br />2. No mining operatics will be located on lands where such operations are prohibited by law <br />(Section 3432.5-115(4)(f1, C.R.S.; <br />3. As the applicaw/operator, I do not have any extraction/exploration operations in the State of Colorado momently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Conshuction Materials <br />(Section 3432.5-120, C.RS J as determined through a Board finding. <br />4. I tmderstand that statements in the application are being made under penalty ofperjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuarrt to Seatia~n 18-8-503, C.RS. <br />Signed and dated this ~ day of <br />Applicant/Operator or Comparry Name <br />State of Colorado <br />County of Deita <br />ss. <br />0 <br />The foregoing iosnument was acknowledged before me this .~2N day of ~ ~4RCI-I 20o by <br />E LaRW ~LAGK as CovNN ~,"~GIAfEER-. of 'DE1-T!a CaINJT1ryr p~~ wtrD <br />~Zt_EvR coacbuA`~X au y corny ca.en~ ~~~ b ,~. VYl~4~lf1" <br />20,r. •,P Notary public <br />KNdIBERLY ay <br />WRItaH7 J^ My Commission expires: \OI 812000 <br />MUST BE IN BLUE INK <br />~.r~w~H,;m us.a~ <br />T$is farm hos been approved by #e Mixed Land Redanatioa Board parsaard to redion 34d3.S-11$CJZS, ajthe Colorado Land <br />Reclamotion Ad for #e Extraction ofConstradiox Materials. Any aperation or xw~fiaatiox ojthis farm shaII rank ix inidbrg oxy <br />permitissaed on #e akered ormodrfraljorm axd aableCt#e operatorto cease axd desistorders and ds~pexakiesjar opaa#rgxiHiaat <br />a permit prtrsaarrt to redian 3¢32-123, C-ILS <br />