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-~- <br />Certification: <br />As an authorized representative of the applicmtt, I hereby certify that the operation described has met the minimum <br />requsem~ts of the following temrs and conditiolns: <br />1. To the best of my lmowledge, all significant, valuable and permanent man-made structure(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 34-32.5-115(4)(e), C.RS.). <br />2. No mining operation will be located on lands where such opazations are prol»bited by law (Section <br />34-32.5-115(4)(f), C.RS.; <br />3. As the applicant/operator, I do not have any extraction exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.5-120, C.RS.) as determined through a Boazd fording. <br />4. I undeastand that statements in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, CRS. <br />Signed and dated this 1 _ ~-~ day of ~ c o rn ~ v -2~. <br />If Corporation Attest (Seal) <br />Title: <br />State of Co~O\"~O ) <br />ss <br />County of ~C~0.vv~S ) <br />.k, : <br />~ ~. <br />4:' <br />~ s? 9 <br /> <br /> <br /> <br /> <br />The foregoing inctr,,.n„~* was aclmowledged before me this ~~I-h day of 1~ C .~opp Im,pQ~ ~~ 3 , <br />by ~~U~ . ~ ~.~(^~~(~ as V P ~ YY1 of d~ ~-i ~Y~C. <br />\\\1\1f111111„I/ff//f/ <br />GjJ. •~ , ..• r~/i <br />:'~~~ Rj-:~; <br />~l....~, • ~~.~' d• <br />Signed: .~G <br />„11,11,1:.,. <br />Corporate Se~~y;or'Eijt;iyaL <br />-P~ ~x,c l~ <br />Notary Public <br />My Comaussion expires: 0`~-~7~ <br />SIGNATIIRES MUST BE Ili' BLUE IPIK <br />M:Imin`aham\v>d~M~OCmn llZdoc (10/1302001) <br />