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<br />Certification• <br />- 6 - <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 39-32.5-11O(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 39- <br />32.5-115(9)(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~loca*_ed on lands where such operations are prohibited by <br />law (Section 39-32.5-115(9)(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. I 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 1989. <br />Signed and dated this ~Y1pi day of <br />p.~,®~.,)_ ,tea /~~~ <br />Apxilican,.~~t..~J/Op~era~.t}('~or nn ~j~ <br />Signed: 14L~llu-rrw~, JtloltVO ~-sf1" ~~~ Signed: <br />Title: /0 Gl1NOA . -~JC~~D_/1(17~'~ <br />, ~L_- <br />~,8~-~l~ T,1.uc~(5 <br />If Corporation Attest (Seal) <br />State of ~~OC~ ) <br />~- ) ss <br />County of ~\\~\~~SaQ ) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this Z day of ~, ~ 1, <br />b ~CO~c~ L7~Q ~ ~ '`~` ~XO~B. <br />y ~ ~~ as •~; ,.Unrir .in ~. ~/~~neP ~ODP fa /Cr'of ~ ~ ~ i /'UCH', nn <br />SANDRA M. WHITE ~~cr-~ C~\ ~~~-~ <br />NOTARY PUBLIC <br />STATE OF COLORADO Notary Public'1 <br />My COrruNsslon Expires O8~15"2004 My Commission expires: dl~`310`~ <br />SIGlU-TURE9 MAST HE IN BLUE INR <br />04/25/97 2821FC0.110 <br />