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• -5- • <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. This mining operation will not adversely affect the stability of any significant, <br /> valuable and permanent man-made structure(a) located within two hundred (200) feet of <br /> the affected lands . (However, where there is an agreement between the <br /> applicant/operator and the persons having an interest in the structure that damage to <br /> the structure is to be compensated for by the applicant/operator (Section <br /> 834-32-115(4) (d) , C.R.S. 1984, as amended) , then mining may occur within 200 feet. <br /> Proof of an agreement must be submitted to the Office prior to the decision date.) <br /> 2. No mining operation will be located on lands where such operations are prohibited <br /> by law (Section 34-32-115(4) (f) , C.R.S. 1984, as amended) ; <br /> 3. As the applicant/operator, I do not have any mining/prospecting operations in <br /> this state of Colorado currently in violation of the provisions of the Mined Land <br /> Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through a <br /> 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 1984, as amended. <br /> Signed and dated this day of 19yam. _ <br /> Bestway Paving Company <br /> Applicant/Operaat'or///� If Corporation Attest (Seal)) <br /> Signed: I xD IL,, Ll Signed:' �I " <br /> Corpo ate Secretary or Equivalent <br /> Title: -1 =:2 _ Town/City/County Clerk <br /> State of e,-7. / e../:. ) <br /> ea <br /> County of <br /> The foregoing instrument was acknowledged before me this _!�' day of ­J�_­ 7 /4r4 , <br /> by _ ,vP/ .� // as /�rir,��i,._d of /'s� <br /> Not Public <br /> My Commission expires: <br /> 28MF.wpf . <br />