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-~- <br />Certification: <br />As an authorized representafive of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />L To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected azea have been identified in this application <br />(Section 34-32.5-115(4)(e), C.R.$.). <br />2. No mining operafion will be located on lands where such operations are prohibited by law (Secfion <br />34-32.5-I15(4)(t), C.R.S.; <br />3. As the applicantloperator, I do not have any extraction/explorafion operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construcflon Materials (Section <br />34-32.5-120, C.R.S.) as determined through a Boazd fmding. <br />4. I understand that statements in the applicafion aze 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.R.S. <br />- pr o3 <br />Signed and dated this ~~ ~' day of A.n~..,~ ,~oz>d~. ~ -; <br />~. <br />~~ If Corporafion Attest (Seal) ~ „~ -~ - ~c <br />Applicant/Operator or Company Name `~f'>,,' ~-. ~'~.~°~'~c~ <br />Signed: ~'%!~z - <br />Title: ~YP S i6>'PYl <br />Signed: <br />C orate Secretary or Equivalent <br />Town/City/County Clerk <br />State of ~~~~~YQ(~ 0 ) <br />ss <br />County of ~~r/ ~ ra,5~ ) <br />The f~o/rpegoing instrument was aclmowledged before~~e this ~ ~ ~~ day of ~~~ , ~/~~~' <br />by / a/~~ S i~2~C/cirsor~ as `~i'~4SiG1fr~ of ~~~/JY.9on ~ ,~i7r, ~ ~i'P <br />~~ <br />Notary Public <br />My Commission expires: ~ ~S-dS <br />SIGNATURES MUST BE IN BLUE INK <br />M:NIW~BDCUIINFORMS@823C012APP 10/17/01 <br />