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REV11265
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REV11265
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Entry Properties
Last modified
8/25/2016 1:22:15 AM
Creation date
11/21/2007 10:21:55 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1994007
IBM Index Class Name
Revision
Doc Date
1/2/1997
Doc Name
CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICTION FORM
Type & Sequence
CN1
Media Type
D
Archive
No
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-~- <br />Certificatioa: <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. To the best of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application 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 (9)(e), C.R.S.). <br />2. 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 />3. As the applicant/operator, I do not have any extraction/exploration 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, C.R.S.) <br />as determined Chrough a 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. <br />Signed and dated this - r day of ~L ~-Q+"~~t ~/ S/ <br />Signed: <br />If Corporation Attest (Seal) <br />Signed: -~p~h..,/ ~...~.C~(r27iYL0 <br />Corpor~t Secretary or Equivalent <br />Town/City/County Clerk <br />State of ~Q'~cL < ~ d ) <br />/// ~ ) s s <br />County of `~ .~ ) <br />The foregoing instrument was acknow//ll1edged before me this 31't4day of ~eCember /9 , <br />by KE)T/~l ,L. SHgRne as I:OMmi55iaNER, of PNIL~~PJ CmuNTy, Co/orndo <br />`~a~P IVST,yTl ` C~GU CG <br />p?A/,~~, Notary Public <br />~~0~ My Commission expires: Nebr. /5, 1998 <br />AVB1- o <br />Sr~rE 0f CO~~~'~ BIQa1TOR88 tlQBT 88 IN HLIIB IHIC <br />06/26/97 2623FC0.112 <br />Title: G~~~~-~~~---o-.--sr <br />
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