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<br />Certification• <br /> <br />-6- <br />As an authorized representative of the applicant, I hereby certify that the operation described <br />has met the minimum requirements of the following terms anfl conditions: <br />1. All necessary approvals from local government have been applied for <br />(Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) <br />in existence at the time this application ie filed, and located within 200 feet of the <br />proposed affected area have been identified in this application (Section 34-32.5-115(4)(e), <br />C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the <br />permit boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law <br />(Section 34-32.5-115(4)(f), C.R.S.). <br />4. As the applicant/operator, i do not have any mining/prospecting operations in the State <br />of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for <br />the Extraction of Construction Nateriale (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements in the application are being made under penalty of perjury <br />and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to <br />Section 18-8-503, C.R.S 1984. <br />Signed and dated this ~ day of ~A A~.F ~K-~. <br />if Corporation Attest (Seal) <br />Applicant/Ope ator <br />Signed: <br />Title: <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of L~D~B'1 ¢~ ) <br />) 39 <br />County of ) <br />The foregoing instrument was acknowledged before me this ~ O~day of ~, / ~~o, <br />by 7C1~.~-~ as of (((/// <br />Notary Public -' ~ _ <br />Hy Commission expires: 3-'a9-~~~ ' <br />___~ <br />0l/02/961821FC0.110 i <br />