Laserfiche WebLink
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 J=/— day of <br /> If Corporation Attest (Seal) - <br /> "Applicant/Ope atg r Company Name <br /> Signed: i ��- Signed: <br /> 1 Corporate Secretary or Equivalent <br /> Title: �C'C S crk Town/City/County Clerk <br /> State of l 'nlr)(CLAO ) <br /> ss <br /> County of Lc rirc\e (- <br /> The foregoing instrument was acknowledged before me this day of ./lC)_rc h fg94 , <br /> by ihn r-A Cn r-\r II as �rCSIC� 1\� of �nnnr II �c �ccrcr S Vic' <br /> cd n n D a �CC n n <br /> Notary Public <br /> My Commission expires: Aa4 (0, <br /> SIGIVOURES MUST BE IN BLUE INK �l <br /> 04/25/97 2823FCO.112 <br />