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-6- <br />. Certification: <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 conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.5-I 10(1)(a)(viii). <br />2. 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 Z00 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-1 IS(4)(e), C.RS.). (NOTE: For 110 operations, the affected area includes all lands delineated by the <br />permit boundary.) <br />3. No mining operation will be located on lands where such operations aze prohibited by law (Section 34-32.5-1 IS(4)(t), <br />C.RS.). <br />4. As the applicandoperator, I do not have any mining/prospecting 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 34- <br />32.5-120, C.RS.). <br />5. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. <br />dated this o2 ~~ day of J~,~ ~ L ©~3 , <br />~---lvl ~le~J~ ~a,J ZTL <br />If Corporation Attest (Seal) <br />Signed: <br />Title: /~ar~>g ~~ <br />State of ~ G r ) <br />'~ )ss. <br />County of c~~/ ) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />~cJ <br />The foregoing instrumenf -was acknowledged before me this ~ ~ day of ~.li~ ~ ~ , by <br />m ~l~ln~'~nea VlQvl _ZlT as ~ of . ~ /a~ ~ <br />.~~''~~ A ~H ~''~. <br />S O •, <br />,.•~~............p <br />-~- <br />'u+q~'',oUBL~O .' <br />M:w,m~nn~~~r~~c~,nanttattoityxeu~F'COLp,`~:' 1 <br />~~ <br />Notary he <br />My fommiasion Ecpin~ <br />My Commission expires: Ileeembe. zs. zoos <br />MUST BE IN BLUE INK <br />