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Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requvements <br />of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and pemtanent man-made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected azea 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 prohibited by law (Section 3432.5-115(4)0, <br />C.RS.; <br />3. As the applicantloperator, I do not have any extractionlexploration 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 tluough a Boazd finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein aze punishable as a Class 1 misdemeanor pursuant to Section IS-8-503, C.RS. <br />Signed and dated this ~-~ day of ~h pv 'o1C01- , <br /> <br />Applicant/Operator or <br />Title: ~2tsic~e~.r~ <br />State of ~l~aa~..o ) <br />ss <br />County of ~A~1'M.tR.. ) <br />Signed: ~r~.s.d,.o_ ~Ln•.n..co-.,.,... Sec. <br />Corporate Secretary or Equivalent <br />If Corporation Attest (Seal) <br />Town/City/County Clerk <br />The foregoing instrument was aclmowledged before me this ~{~ day of ~~ ~ ~ , <br />by R;ca_aP~ ~x.~..~u as P2>/si~,su.~-1- ofC~~.~ 1.ao~1 fit ~n.~~i.~c~1~~~. <br />~Y.r` =V\I~~, <br />Notary Public <br />My Commission expires ` 1M d~ ~~ 9.0~ a <br />T'~ <br />- ~;,,, ' . <br />SIGNATURES MUST BE IN BLUE INK -'~ ~'~~~ <br />.i-.. <br />.~ <br />,~ - " <br />