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.. <br />-~- <br />Certificatioa• <br />As an authorized representative of the applicant, I hereby certify that the operation <br />described has met the minimum requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application is filed, and located within 200 <br />feet of the proposed affected area have been identified in this application (Section 39- <br />32.5-115(9)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by <br />law (Section 39-32.5-11514)lf), C.R.S.; <br />3. As the applicant/operator, I do not have any extraction/exploration operations in the <br />State of Colorado currently in violation of the provisions of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials (Section 39-32.5-120, C.R.S.) <br />as determined through a Board finding. <br />9. I understand that statements in the application are being made under penalty of <br />perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br />pursuant to Section 16-8-503, C.R.S. <br />.~ <br />Signed and dated this ~ day of JU1~~ 1~1_. <br />~~e~ucuG. you w`~ <br />Applicant/Opera~tor~J or Company Name <br />Signed~;~ /~l~~Y//~P`/ <br />, <br />Title: ~drn.-,-r~. h- <br />If Corporation Attest -(Seal)- <br />Signed: ~~~y/~~~~~~ <br />Corporate Secretary or 4?"quivalent <br />Town/City/County Clerk <br />State of C~C~/f~~-`-U ) <br />~~77~~~~ 7 ss <br />County of /Y/uV1~e ~Gl[GL ) <br />`tl~ <br />The~..flor~e~g~oing instrument was ackno/w`ledged be/f(ore me,,/thi/s ~ day ofdvu'ue- ~~q , <br />by Iv~LW~u.S ~)2QUe1( ~~~g~~i~L.olu..lc~ ~d~c~vri.~bJapct/ of {~'IAA.l2L~UNtiG; ~(.i-ft`E-~,~ <br />a~~pN KI Mf<p- k- <br />_~.~pTAFtyk y4c <br />_' -0O-o• ~ <br />%~'OUBL~~'.+ooa'' Notar Public <br />' ~~ry'~~OFiCO `D~P~ <br />+avCOMMISSIONEXPIRES: My Commission expires: ~I(!-rtL.Z~~~~ <br />JUNE 23, 2001 <br />SIGlU1TIIRES MOST BE IN BLUE INR <br />04/25/97 2323FC0.112 <br />