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7 — <br /> Certification: <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 34- <br /> 32.5-115 (4) (e) , C.R.S. ) . <br /> 2. No mining operation will be located on lands where such operations are prohibited by <br /> law (Section 34-32.5-115(4) (f) , 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 34-32.5-120, C.R.S. ) <br /> as determined through a Board finding. <br /> 4. 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 18-8-503, C.R.S..� <br /> Signed and dated this �/— day of 4LAA / <br /> � If Corporation Attest (Seal) <br /> Applicant/Ope at r Company Name <br /> Signed:�i � /�( �� Signed: kt__� �. r✓..C.�� <br /> Corporate Secretary or Equivalent <br /> Title: �1'c'SiC�C(l Town/City/County Clerk <br /> State of ( .nInirrAc� ) <br /> I ss <br /> County of <br /> The foregoing instrument was acknowledged before me this 31 day of 1t0_rr <br /> by �LcLrr rA as —Drr-_'idc' �t of <br /> �I l <br /> CrAR R r r �rr) � <br /> Notary Public <br /> My Commission expires: 'Ma. .e <br /> a <br /> SIGlATURES MUST BE IN BLUE nM <br /> t04/25/97 2823FCO.112 <br />