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<br />- 7 - .9~n..,..y~.~. <br />Certification: <br />~~ <br />As an authorized representative of the applicant, I here that the operation described has met the minimum <br />requirements of the following terms and ~:onditions: <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-I15(4)(e), C.R.S.). <br />2. No mining operation will be I~~cated on lands where such operations are prohibited by law (Section <br />34-32.5-I IS(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 Board fmding. <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 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />tk <br />Signed and dated this / / - day of c1a~,vl ua r~ ~ ~ D ~ <br />ApplicanUOperator or Company Name <br />Signed: "[i~Zf yi ~'~ <br />If Corporation Attest (Seal) <br />Signed: ~p~,vv~y`/'( ci/~,~-„...~.~I <br />11 Corporate Secretary or Equivalent <br />Title: 1~a!'t¢ ~ ~eyLC Town/City/County Clerk <br />State of C'~ <br />ss <br />County of tt.rr'>~. Q .) <br />The f~regoing instrument was acknowhxlged before me this ~_ day of 11~- ~ <br />by FPM y. ~~;1~111t2~1 _as f]Ir^t~ot~ of ~`,rv.e:~~> .c_`~1C~2L1 ~~tl <br />Qy QUBLIC d\.1„ D Q~ . ~ t~l ~a~c <br />hQ,~• p+.' ~'.O Notary Public <br />• ~'t :O <br />r ~ .°O My Commission expires: ~`C'd,~-^ <br />SIGNATURES MUST BE IN BLUE INK <br />M:VAMSHAREIV$FORM517l7JCOI2MP 07/10/99 <br />