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~_, ~ .. _ <br />- 6 - <br />S~ertifica[inn: <br />As an authorized representative of the applicant. I hereby certifi' that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />All necessary approvals Gom local government have been applied for (Section 3d-335-I 10(I)(a)(ciii). <br />2. To the best of my knowledge. all significant, valuable and pe-mongol man-made structure(s) in existence at the time this <br />application is fled, and located within Z00 feet of the proposed affected area have been identified in this application <br />(Section 3d-32.5-1 i5(4)(e), C.RS.). (i`iOTE: For 1 LO operations, the affected area includes all lands delineated b_v the pem[i[ <br />boundary'.) <br />3. No mining operation will be located on lands where such operations are prohibited by la~v (Section 34-32.5-1 15(~4)(f), C.RS.). <br />4. As the appGcantloperator, I do not have any mining/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 Iviaterials (Section .i•3-32.5-120, C.RS.). <br />5. I understvtd that statements in the application aze being made under penalty of perjury and that false statements made herein <br />aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS 1984. <br />k~ <br />Sided and dated this ~ day of ~ ~- c. ~-, , 3 a „ v <br />ApplicanUOperator <br />Signed: I 1... 1 I ,~i <br />Title: ~ ~r~, a-,.e., ~ ~c ~ ~.r <br />State of ~~ <br />\) ss. <br />County of ~ ~-v <br />The regoin instrument was aclaowledeed before me this <br />/a !J ~ Liir-G)o+~ as t~~~c= <br />EiLEEN M, <br />ZUBAI <br />If Corporation Attest (Seal) <br />Signed: ~~. U'~L.._.-L '. <br />Corporate Secretary or Equivalent <br />TownlCity/County Clerk <br /> <br />,r'•, ,:~o ,Public v <br />yt'••.......••' P~ <br />OF C0~ 6~41v Commission expires: ~`' d ;~ c c' 2 <br />SIGNATURES ivIUST BE IN BLUE Ir7i <br />hI:VNIMSI-WREIVSFORM54'.821COIO.APP 0625/99 <br />