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-?- <br />Certification: <br />As an authorized nptraentative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: . _ . r ,. . <br />1. To the best of ary knowledge, all significant, valuable and permanent man-made structure(s) inexistence 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.R5.). <br />2: No mining operation will be located on lands where such operations are prohibited by !aw {Section <br />3432.5-115(4~t), CRS.; <br />` 3. As the apphcant/operawr, I donot have a~ extraction/exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Rechunarion Ad for the Bamaction of Cottswcdon Materials (Section <br />3432.5-120, CRS.) as determined through a Board finding. <br />d. I understand tLat statements in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and dated this 5th day of APRIL <br />OTERO COUNTY <br />ApphcantlOpecatar ~ ~~Y Name e <br />~,Y,~.~, S. ~t3~,~ <br />PUBLIC WORKS SUPERVISOR <br />of ) <br />) ~- <br />ty of ) <br />2004 <br />Q (~+ I£Carporatian Attest (Sea!) <br />.(~G~....... ,Ofj <br />O , . 2~ <br />.1JE~~. ~ igt~: <br />~`~.... :.~ Corporate Se~re<ary or Equivalen <br />~O R p00 Town~ciry/co~mty clerk <br />foregoing instrument was acknowledged before me this day of <br />as <br />of <br />Notary Public <br />My Commission expires: <br />by <br />SIGNATURES MUST BE IN BLUE INK <br />ttx.mo paisrmoq <br />