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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. All necessary approvals from local government have been applied for <br /> (Section 34-32 .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 appl:_cation 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. ) . (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 /> 4. As the applicant/operator, I do not have an,7 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 34-32.5-120, <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 a.-e punishable as a Class 1 misdemeanor <br /> pursuant to Section 18-8-503, C.R.S 1984. <br /> i <br /> Signed and dated this a� day of <br /> � �. <br /> J�LcHIPA ( " �' f YC • 7:f Corporation Attest (Seal) 'Vo '5"W 44" c' <br /> Applicant/Operator <br /> Signed: S:igned: ��jJ9(�'�'-/ <br /> Cdrporat ecretary or Equivalent <br /> Title: �J " / Town/City/County Clerk <br /> State of <br /> ss <br /> County of t <br /> The foregoing instrument was acknowledged before me this 2'4/day <br /> by Q2, as tL' of <br /> i <br /> REGLIVaD. Notary Public <br /> MAR 1 .1" 1999 Myr Commission expires: <br /> Division of Vr._�als&Ger.1 <br /> SIGNATURES MUST BE IN BLUE INK <br /> I <br /> 04/25/97 2821FC0.110 <br />