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-~- <br />Certification: <br />As ao authorized representative of the applicant, I hereby certify that the operation described has mct the minimum <br />requaem~ts of the following terms and conditions: <br />1. To the best of my knowledge, 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 operations are prohibited by law (Section <br />34-32.5-115(4)(f), C.RS.; <br />3. As the applicanUoperator, 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 Board finding. <br />4. I understand 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 ~_ day of ~~9-(iY~ <br />Title: 1~C(Zt f1~s ~ ~P~lGfiu-~`~-r <br />State of Colorado <br />ss <br />County of .UP R ~ r 1 <br />If Corporation Attest <br />Signed: <br />The foregoing instrument was acknowledged before me this 7 ~ day of _ /~/~r~0'~~/~ , ~~~ <br />by ~.~ v t N ~ n~u ~ as C~6- G oY ~] Pit o(~ ~~+at i~_ <br />~r'~-a <br />LINDA S. BACH <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />My Commission E~ires Ofll17/2004 <br />,~-~.s, <br />otan Public <br />My Commission expires: $Ih ~~u~ <br />SIGNATURES 1VIUST BE IN BLUE INK <br />Mimmishue`safa®cM.~hw.tiw ll2Aoc (I9l15(7L01) <br />Town/City/County Clerk <br />