Laserfiche WebLink
- 6 - <br />Certification: <br />As an authorized representative of the applicant, 1 hereby certify that the operation described has met the mmimum requirements of the <br />following terms and conditions: <br />1. All necessan• approvals from local government have been applied for (Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made swcture(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-1 l5(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated b_v the permit <br />boundary.) <br />No mining operation will be located on lands where such operations are prohibited by lavv (Section 34-32.5-115(4)(fj, C.RS.). <br />4. As the applicant/operator, I do not have any tnining/prospecting operations in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.RS.). <br />5. I understand that statements in the application are being made under penalt<~ of perjury and that Calse statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS 1984. <br />Signed and dated this ~3 ~ day of ADD ~'~ / , ~~ <br />~9.5 Rini:-~nr C_ ou„~,, <br />Applicant/Operator <br />Signed: /) G~rJ' ~ ~/~-~-rte <br />Title: l ' 0 U.Nt y ~~. 14 //~/Q R <br />if Corporation AttestSSeal) - <br />Signed. L ~~ <br />Corporate ~ retary or Equiva ent ~~- <br />State of ) <br />ss. <br />Counh• of <br />Tatiem~italCounty Clerk <br />The foregoing instrument was acknowledged before me this /3 ~ day of ~'~'~ <br />f:nbe~r ~}, L~Ce le.o as ~.,0,/tT `pLI~N/Vu,Cro_r <br />°~ lb_PNA-IeP .~ . (}vNZ~~eS a.s <br />oit/ r/ ~ , by <br />18050 HWY 12 Notan Public <br />WESTON, CO 81091 My Commission expires: _ <br />SIGNATURES MUST BE IN BLUE INK - .~ ~ ' ~ <br />M:UIIMSHARE\VSFORMS\2821COIO.APP 0625/99 ~ ' •" - <br />