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06/21/2006 15:50 2637456 C~RDILLERAN PAGE 02/04 <br />-~- <br />CeLtlf`icatinn: <br />If Corporation Attest (Sea' <br />As an suthoriud representative ofthe applicant, I hereby certify thatthe operation describedhas metehe minimum requirements ofthc <br />following terms and conditions: <br />Al! necessary approvals 9nm local government have been applied for (Section 34-32.5.110(1)(a)(V1II). <br />2. To the best of my knowledge, all significant, valuable and permanent. manmade structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 3432.5-115(4xe), C.R.S.). (NOTE: For 110 operations, fhe affected area includes all lands delineated by the permit <br />boundary.) <br />3. Na mining operation will be located oa lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.R.S.), <br />4. As the applicatttloperator, f donot have any mining/explatation operations in dte State of Colorado civrernly in violation of <br />the provisions of the Co]otado Land Reclamation Act forthe Extraction of Construction Materials {Section 34.32.5-120, C.RS.). <br />5. 1 understand that statements in the application are being made under penalty ofperjury and that false statements made herein <br />are purdahable u a Class 1 tnisdemeanoz pursuant ip Section 18.8-503, C.RS. I984. <br />Thlsjorrn bas been approved by tbehllnedLarrdReclamation $oard pursuant to section 34-325-1I gC.RS., ojtbe Lblarada Land <br />ReclamadonAetjorrbeExtraetfnnojConatruetlonMateriaLc ARyallootionormodficaaonojrhirjormshallresulttnvotd(ngany <br />perm!! issued on the altered or modified john and subjer! the operator to cease and deals! orders and civil pemltfes jot operating <br />without a permit pursuant to section 34-325-123, GRS. <br />Signed and dated this 7 ~ day of d '"^ f ~ O 0 ~ ..:nw~n, <br />ApplicatNOperator <br />Signed.~~ <br />Title: SP..v1.~~.-- P~ t~ ~~ 5 <br />~ V/f <br />State of r>/ aYf..//.'~~_,_,__) <br />ss. <br />County of _ ~~ ..ti ) <br />Signed; <br />~~~~~~~~ <br />APR 1 8 23106 <br />Oiv%siun nl IWincrnls and Geology <br />:~ , <br />~• ::' <br />Corporate Sectctaty Ot ~'•I~G ~{ 1) ~Z. <br />'•.~ u.,... ~..~ r,~ <br />Town/City/Coon., <br />Tire foregoing instrument was aek~~no//wladged before me this "~ 7 day of .2n~ <br />_,_by s~.c~ ~ '/- JSl~~'Yr~ as ~}[~^ of <br />GAIL S g ,~.GMafyFublic <br />V1£88 F; ~/-lam <br />~ a y~ My Commission expires: i~or7 ~ <br />I1VIC <br />M:\minLalvrelvstbnnslCAnsmtctian110 (Approved OS/11lZae5J <br />