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,- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has alet the minimum requirements <br />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 this <br />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 miuing operation will be located on lands where such operations are prohibited by law (Section 34-32.5-I 15(4)(f), <br />C.RS.; <br />3. As the applicanboperator, I donor 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 Constmction Materials (Section <br />34-32.5-120, C.RS.) as determined through a Boazd finding. <br />4. 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. <br />Signed and dated this ~~iln day of ~~ ~~ ZOO 2 <br />Four ~-~ Aggre~ca-f~s l i ~' <br />Applicant/Operator or Company Name <br />Signed: ~~` <br />~j i <br />Title: ~ / /lip ~ 0 4 ~e 2 <br />State of r„1,,,-ado ) <br />ss <br />Counlyof Monteuzma ) <br />If Corporation Attest (Seal) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this 20 eh day of Mal, inn ~ , <br />by Aryol B iml e~ aS Man a$ur Of Fn„r Crnro~ e~ nro~ rr.r <br />R:~ <br />' i~_....,.- '~ F.. <br />°~~' <br />°'r~'-y~";\ v <br />Signed: <br />Notary Public <br />My Commission expires: 04 / 03 / 06 <br />?il ~~ ~; . <br />"' `-- - SIGNATURES MUST BE IN BLUE INK <br />