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-6- <br />CertiScation: <br />As an audrorized representative of the applicant, I hereby ~Y that the operation described has met the minimum requirements <br />of the following tams and conditions: <br />All necessary approvals from local govemmeat have been applied for (Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my lmowledge, all significant, valuable and permanent man-made stnrcdue(s) in existence 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 3432.5-115(4)(e), C.RS.). (NOTE: Fm 110 operations, the affected area includes all lands delineated by the <br />Permit boundary) <br />3. No mining opetati~ will be located on lands where such operations are prohibited by lacy (Section 34-32.5-115(4xf), <br />C.RS.). <br />4. As the applicant/operator, I donut have s~ mining/prospecting operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extiartion of Coushuction MataiaLs (Section 34- <br />32.5-120, C.RS.). <br />5. I understand that statema<ts in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. <br />Signed and dated this <br />day of January 2006 <br />/~uSSe /~~~~vc h ~~ fz~rtlis'1~ <br />ApplicantlOperator <br />Signed: <br />Ben J. Rogers <br />Title: <br />weer anager~~~~ <br />State of Colorado ) <br />ss. <br />County of Rio Blanco ) <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing inatmmwnt was aclmowledged before me this 17th day of January 2006 , by <br />Ben J. Rogers ~ Owner/Manager. C•-,, pf Russell Ranch General Partnership <br />o: ~pTq,4~ C.~,~1 <br />_ A1- YA` n n <br />~~B L ~ G'. ~oota,,rv Public <br />. of Ca„~~~My Commission expires: ~- ~- 0 6 <br />SIGNATURES MUST BE IN BLUE INK <br />MMtml~arclvd~lCms4uctiml l0 (30/15/5002) <br />