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PERMFILE62016
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PERMFILE62016
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Entry Properties
Last modified
8/24/2016 11:08:29 PM
Creation date
11/20/2007 7:25:12 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1981275
IBM Index Class Name
Permit File
Doc Name
CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
Media Type
D
Archive
No
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,_ <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requtremrnts <br />of the following terms and conditions: <br />1. To the best of my Irnowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />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.RS.). <br />2. No mining operation will be located on lands where such operatans are prohibited bylaw (Section 34-32.5-1 IS(4)(f), <br />C.RS.; _ <br />3. As the applicandoperator, I donot 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. I 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 ~~~.ceic .~00 / <br />~i~Ghu /~. ~GT¢Sa-~~/ <br />~rLs2Q ~ ~-~~i1.Cd~ri If Corporation Attest (Seal) <br />Apphcant/Operator or Company Name <br />Signed:lt V/~~~ ~". ~~~1~~~ Signed: <br />Title: ~ ~,Gi'~r~~ <br />t <br />State of Colorado 1 <br />ss <br />County of Rio Blanco ) <br />Corporate Secretary or Equivalrnt <br />Towv/Ciry/County Clerk <br />The foregoing instrument was acknowledged before me this 25th day of October 2001 <br />by Diana K. Watson ~ Applicant pf Stout-Amick Pit <br />`~~cr!.rk.J <br />Notary Publi' <br />My Commission expves: 8-6 -04 <br />SIGNATURES MUST BE IN BLUE INK <br />
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