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Certification: <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 /> 1. To the best of my knowledge,all significant,valuable and permanent than-made struci ue(s)inexistence 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 34-32.5-1 l5(4)(e), C.R.S.). <br /> 2. No mining operation will be located on lands where such operations are prohibited by law(Section 34-32.5-115(4)(f), <br /> C.R.S.; <br /> 3. As the applicantloperator,I do not have any extraction/exploration operations in the State of Colorado currently in <br /> violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br /> 34-32.5-120, C.RS.) as determined through a Board finding. <br /> 4. 1 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. <br /> Signed and dated this day of rI doh <br /> IfCorgoration Att&t,(Seal) <br /> Applicant/Operator or Company Name = ; <br /> .7 <br /> Si ed. Signed: <br /> r <br /> Corpotate.SecTctary or,'ngii\alert <br /> Title: PR F,5 Town/City;County.Clerk <br /> Stateof (• OlOro.& ) <br /> )ss <br /> County of )� D <br /> The foregoing instrument was acknowledged before me this At.* day of t'\'\c ✓c %. <br /> by C-rt'y& A. as of (� pm iltell ( rid �OnS FZtiC. <br /> Notary Public <br /> MY omm on expires:ires: 3 O <br /> cP <br /> SIGNATURES WST BE IN BLUE INK <br />