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- 7 - <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements 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 azea 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 by law (Section <br />34-32.5-115(4)(fl, C.R.S.; <br />3. As the applicanUoperator, I do not have any extraction exploration operaflons 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 fmding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this z~ ~ day of , ll'~Pj , 7_lJ0 ~ . <br />Corporation ,,__^__.. ~ ^ <br />Ha 11-Irwin .~^^ ^ _ Tf Corporation Attest (Seal) _ - <br />Applicant/Operator or Company Name <br />Sign Signed~C~~~ _ <br />Corporate Secretary or Equivalent <br />Division Manaoer <br />Town/City/County Clerk <br />State of ~ o~ ' ~~ ) <br />County of ~~~Y~(.U~- - ~ ) <br /> <br />The\\foregoing instrume t was/ acknowledged before me this ( I day of ~UL~~ /' , ~~ <br />byJlm Y~Ic~~'r~n/R as~~V~Sion Vl~a.naa, r of NC1~~-Iful,~ ~f fq~j~rl <br />~~_ _ i <br /> <br />My Comtnission expires: <br />SIGNATURES MUST BE IN BLUE INK <br />~onvm <br />