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<br /> <br />Certification: <br /> <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />1. To the best of rry knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />application is fded, 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-I IS(4)(Q, <br />C.RS.; <br />3. As Ute applicant/operator, I do not have any extraction exploration operations in the State of Colorado curently in <br />violation of the provisions of the Colorado Land Reclamatiom Act for the Extraction of Construction Materials (Section <br />34-32.5-120, C.R.S.) 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 made <br />herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and dated this 2~ day of , 7~b / <br />David Lincoln <br />ApplicandOperator or Com ame <br />Signed: <br />[f Corporation Attest (Seal) <br />Signed: NA <br />Corporate Secretary or Equivalent <br />Title: O w n e r <br />State of Adams ) <br />ss <br />County of Colorado ) <br />Town/City/County Clerk <br />The foregoing instrttment was aclaowledged before me this ~ "~ day of A p r i i <br />by navid Lincoln as Owner of Propert <br />.~oeco~_eee;vvvv <br />,•' c$.Q`~ ~1o FLF,1~~?i "moo <br />.~ <br />oa <br />~ .o. J <br />n <br />~ 7L~~ p <br />;. G .°oo .a~- <br />'~ ~=e,, <br />2001 <br />~~~ <br />Notary Public <br />My Commission expires: 6/ 2 9/ 2 0 0 4 <br />SIGNATURES MUST BE IN BLUE INK <br />