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<br />-~- <br />Certification: <br /> <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. 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 area have been identified in this application <br />(Section 34-32.5-I IS(4)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations aze prohibited by law (Section <br />34-32.5-IIS(4)(f), C.R.S.; <br />3. As the applicandoperator, 1 do not have any extraMion/explomtion operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the ExtraMion of Construction Materials (Section <br />34-32.5-120, C.R.S.) as determined through a Board fmding. <br />4. 1 understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class I misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this ~ day of ~tLtC'.~ ~D-O ~ <br />toe stern DSObile Northern, Inc. <br />Applicant/Operator or Company Name <br />If Corporation Attest (Seal) - <br />Gary J. Tuttle - ~ - - <br />Signed~~iLCX Dc~~-iL,~y_~'"c~ <br />Title: Vice President of Regulatory Affairs <br />Countyf - ~-~rl !/P v j ss <br />Town/CitylCounty Clerk <br />the foregoing instrument was acknowledged before me this a~ day of NtltiLG~~ ~ L, <br />by 21'rc/toe,1 ~..Sl~yQlton, as UCa~Pres~i{tnt of /,(~P<~~rr~ //f~,~e /~rt~er//r_T,.n~, <br />'r~~OETTE <br />:r"~ ti~F ~C.e~/!ir ~6'GLf~f727~~ <br />~QTAR y by tary Public <br />-d--0--P <br />°UBLIG:oo My Commission expires: dS36 ADO <br />SIGNATURES MUST BE IN BLUE INK <br />Asst, Secretary _ -_-, <br />Signed: ~/il ~ ~(/~ <br />Corporate Secretary or Equivalent <br />M1AUNlSXARE\VSFIXlM5VB27C017APP OLI099 <br />