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PERMFILE66125
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PERMFILE66125
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Entry Properties
Last modified
8/24/2016 11:12:03 PM
Creation date
11/20/2007 9:10:58 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2002111
IBM Index Class Name
Permit File
Doc Date
10/14/2003
Doc Name
Revised Permit Application form and bond calc
From
Greg Lewicki and Associates
To
DMG
Media Type
D
Archive
No
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-~- <br />Certification: <br />As ao authorized represearative of the applicant, I hereby certify that the operation des(aibed has met the minimum <br />requirem®ts of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and pemtanent man-made structure(s) inexistence 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 34-32.5-115(4)(e), C.RS.). <br />2. No mining operation wiU be located on lands where such operations are prohibited by law (Section <br />34-32.5-115(4xf), C.RS.; <br />3. As the applicant/operator, I do not have a~ extraction exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.5-120, C.RS.) as determined through a Boazd Ending. <br />4. I underst~d that statements in the application are being made ands penalty of perjury and that false statements <br />made herein are punishable as a Class I misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and dated this 29 th ~,of September 2003 <br />Elam Construction, Inc. If Corporation Attest (Seal) <br />Applicantl ~ y Name <br />Sign Signed: <br />Corporate Secretary or Equivalent <br />Title: President <br />State of Colorado 1 <br />ss <br />Counri~of Mesa ~ <br />The foregoing instrument was acknowledged before me this _ <br />by Harold F. Elam ~ President <br />M:~mivls6aeNaformsMmmucrioy lt2doc (10/15/7A01) <br />Town/City/County Clerk <br />~~~ davof S~tcu~~~ x003 <br />of Elam Construction, Inc. <br />SIGtiATL72E5 iVIUST SE IIV` BLL`E TiVIZ <br />~_ %- <br />.~`'~, <br />My Co~rission expires: I ~~ J~ <br />
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