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— 6 — <br /> Certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> described has met the minimum requirements of the following terms and conditions: <br /> 1. All necessary approvals from local government have been applied for <br /> (Section 34-32.5-110 (1) (a) (viii) . <br /> 2. To the best of my knowledge, all significant, valuable and permanent man-made <br /> structure (s) in existence at the time this application is filed, and located within 200 <br /> feet of the proposed affected area have been identified in this application (Section 34- <br /> 32.5-115(4) (e) , C.R.S. ) . (NOTE: For 110 operations, the affected area includes all lands <br /> delineated by the permit boundary. ) <br /> 3. No mining operation will be located on lands where such operations are prohibited by <br /> law (Section 34-32.5-115(4) (f) , C.R.S.) . <br /> 4. As the applicant/operator, I do not have any mining/prospecting operations in the <br /> State of Colorado currently in violation of the provisions of the Colorado Land <br /> Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, <br /> C.R.S. ) . <br /> 5. 1 understand that statements in the application are being made under penalty of <br /> perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br /> pursuant to Section 18-8-503, C.R.S 1984. <br /> Signed and dated this _/ day of <br /> 70_m�'5 Tom ' Sc I cm -e C If Corporation Attest (Seal) <br /> App79441LA� <br /> t/Opera r <br /> i <br /> Signed: �J 2 Signed: <br /> Corporate Secretary r Equivalent <br /> Title: Cho-; leilh a n Town/City/County Clerk <br /> State of l/ o/o radn ) <br /> 1 ) ss <br /> County of l�remo{7 /- ) f{, <br /> The foregoing instrument was acknowledged before me this day of (�2 1 , <br /> by ��()LV)V 4 , SC/l�!/Pi2 as CI OI —/?IQ /1 of e-/770al 0(to <br /> _ - Notary futlic <br /> My Commission Expires <br /> .,^.�!y Commission expires: rNa-9A.90n9 <br /> SIGNATURES MOST BE IN BLUE INK <br /> 04/25/97 2821FCO.110 <br />