Laserfiche WebLink
-~- <br />Certification: <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) 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 will be located on lands where such operations are prolu'bited by law (Section <br />34-32.5-I IS(4)(f), C.RS.; <br />3. As the applicant/operator, I do not have a~ extractionlexploration operations ur 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.RSJ as determined through a Board finding. <br />4. I 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 1 misdemeanor pursuant to Section 18-8-503, CRS. <br />Signed and dated this oZ7 day of ~ D / C r't$E/~ a O4 ~ . <br />ApplicantJOperator or Company Name <br />Signed: ~w <br />Title: ~/~SL~./ 1 <br />State of 1:t7~tJ /L~41J Z1 } <br />ss <br />County of ~lt I~iL(7 1 <br />~~ <br />F,~ -_': - <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me ties ~Z_ day of ~~/ E~~2 200 2 <br />by ,i ~ as ` <br />Of ~ . ~.c5,~r,y c1v$%RuCT.`ad C~v <br />J < <br />... , ~ <br />~>~'`,. ~ My Commission expires: ~ s2`O ~'~ ~ W ~O <br />\fi . <br />.~,~~' ,. 9 ~. <br />~~ , .~;~, <br />-~~~''*^~~~^""-,;"'C SIGNATURES :~Ii3ST BE Ihi BLUE Ii`1K <br />n:~ «u~ nzm~ raurzooi <br />~' <br />