Laserfiche WebLink
<br />-~- <br />Certification: <br />As an authorized representative of the applicant, 1 hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />I. 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.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited bylaw (Section <br />34-32.5-I I5(4)(f), C.R.S.; <br />3. As the applicant/operator, 1 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.R.S.) as determined through a Boazd finding. <br />4. I understand that statements in the application aze being made under penalty of perjury and that false statements <br />made herein are punishable as a Class I misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this ~ day of <br />BjF%T l .ovn/ /F~fJIII ~ ~~J.~%/JJt~ <br />A~p4ieaat(Operator or Company Name <br />aC Si~~ed: <br />Titie:~- - <br />State of ColO,~i9Da ) <br />~FFi9T ) ss <br />County of ) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this 1 o+t-h day of .(]M~-ohQ~ . 2._oor, , <br />by `~{„ ,.. c ~Q "~',,..v-c as ~ ~ n d C , , ~ P .-. „ ~.. _ of vv. n-C-(=n ~- l~~.. ~ „~!-" <br />7pF~~l ~..rJ~~ <br />~, ~_ <br />__ `. - <br />Notary Public <br />My Commission expires: ~ -z. o -.tno2 <br />SIGNATURES MUST BE IN BLUE INK <br />M:UUMSHARE\VSFOPALSV82JCOI7.APP 07/IW9o <br />