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-~- <br />Certfication: <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 wnditions: <br />1. To the best of my laowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified m 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 3432.5-1 IS(4)(EJ, <br />C.RS.; <br />3. As the applicanUoperator, l do not have any extraction exploration operations in the State of Colorado currently th <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Constrction Materials (Section <br />34-32.5-120, C.RS.) as determined through a Board finding. <br />4. I understand that statements in the applicatiom are being made under p®alty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and dates this 2 7 r~` day of S t pT E M B E 2 Z O O y <br />C'/><5 i LC L o/VC2 E TF ~ompgn/~/ If Corporation Attest (Seal) <br />ApplicanUOperator or Company Name <br />Signed: ~~~'/ /// • O~Li~/i'~!/ <br />Title: (/ ZG E / iZ,[_ sl /~t~^1 i <br />Signed: ~ /1 - r.. ~J~ <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of ~O~o('C~c~ I <br />_ ) ss <br />County of ~ I- PG S v I <br />The foregoing instrument was acknowledged before me this z } day of S e ~+e r~~ <br />by~~~(r I/:. i as~t ~~PSIt~Pn~ of S~~P ~'W~.t'~~~. <br />Notary Public <br />~, - <br />- -~ f My Commission expires: ~ 2 I y l <br />_ .__ - <br />- .~~ <br />SIGNATURES'!VIIJS'I`B,~'I1~BLUE INK <br />