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~. <br />- 6 - <br />Certification: <br />BELVEAL GR,4VEL PIT <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. All necessary approvals from local government have been applied for <br />(Section 39-32.5-110(1)(a)(viii). <br />2. 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 39- <br />32.5-115(9)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands <br />delineated by the permit boundary.) <br />3. 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 />9. As the applicant/operator, I do not have any mining/prospecting 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 39-32.5-120, <br />C.R.S.). <br />5. 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 1969. <br />Signed and dated this ~~ day of e„o,~~r ~nnn. <br />Tim Chari,lnn Flhorh !'n RF.R Fn rom Cim If CO OI ~rlx <br />la Division rP .~ '~ <br />Applicant/Operator ~~ ~~- <br />~` ` ' <br />Signed /ice ~~' ~ Signe~ti <br />,~~ ~~ <br />Title: Elbert County R&B Foreman Simla Divisio~• S ~:.~~ <br />~~i 0~ :F9 <br />State of COLORADO )) ss ~~~~4~~N'D'01, <br />County of ELBERT ) <br />(Seal) <br />_Eary or 'Equivalent <br />tr''County Clerk <br />The foregoing instrument was acknowledged before me this zy_ day of AUGllST 2000 , <br />by TIM SHERIDAN as FOREMAN of SIMLA ROAD ~ BRIDGE-ELBERT CTY. <br />KIM GABARDI <br />NOTARY PUBLIC <br />STATE OF COLORADO otary Public <br />My Commission Expires April 21, 2004 My Commission expires <br />SIGNATURES MOST SE IN BLIIE INK <br />04/25/97 282:FC0.110 <br />