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-8- <br />As an authorized representative of rite applicant, I hereby certifythat the operation described has met the mirrimum roquirerrrerlts <br />of the following terra and conditions: <br />t. To the best of my knowledge, all significant, vaiuabk arrd pemlanent man-made structttte(s) in 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 3432.5-115(4xe), C.RS.). <br />2. No mining operation wilt be located on lands where such operations are protdbited hY taw <br />(Section 3432.5-115(4xfj, C.RS.; <br />3. As the applicanVopetatar, I do not have any extractioa/exptotation operatiens in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials <br />(Section 3432.5-120, C.RS.) as deterrrrined through a Board finding. <br />4. I understand chat statements in the application are being made utter penalty of perjury and that false statement <br />made trerein are punishable as a Class I rrtisderrteatror pursuant to Sectien I8-8-503, CRS. <br />7flllr fors hm boar apprororJby lbe A/brd Las/ Reaafasodss doari/ pmsast to rerNow 3I-3Z5-]I2,C.lLS, ofdk Colorado Lowt <br />RulawatloaActjordreF.rlr~rnkurojCowahaedosMa4~o~ AsyaAter:rNoworwodrJkatlowojthiaforersl6d/rewkisvsilbrgesy <br />penult Lxrrred os the a&enrd or so~/lad jars as/ reb~aa tlYt eperarer ro eeasr es/ desbf orders as! crvll ptsalMus for operaaGg <br />rr6liosr • penriYpersrrarrr m sra/os 3I-325-1?3, GR.S <br />Signori and dated this ~ sT day of _ ~y ~ c ~, `~ e ~~ Z yv (.v , <br />~~ ~ ~l ;~. (>ci((~relivl-4 <br />~GCrh urc~ J. ~-au.dr eu~.tl~ <br />ApplicanUOpetat~iy e <br />signea_ ~,vd- <br />Title: d W n ~r ~ <br />State of Cr-tLC~~,~(~ ) <br />ss. <br />County of ~ L(3o2.T ) <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this ~ 5T day of ~~i~V E/yl li~y2 , <br />_, by~Ant l €L ~ - C"7 AU D"i?_E0.U LT 83 <br />Jv.D ~Al:(3A2A -~ -GAuD{ZEAu~T <br />My <br />SIGNATURES MUST BE IN BLUE iNK <br />M:bM1v~Y'noeeecvm I n.Ox (Approved OSlI I r1W3) <br />If Corporation Attest (Seal) <br />s;gnea: <br />corporate Secretary or Equivalent <br />~;'NdTA R y ~'. <br />~N <br />~'rJ ~ <br />'>3~~ ~ ®~ ..aQP <br />~~''~~.. CR C~~;r~`` <br />aoo~ <br />