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-~- <br />Certification <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements ofthe following terms and conditions: <br />To the best of my knowledge, all significant, valuable and pennanetrt 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 <br />this application (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)(1), C.R.S.; <br />3. As the applicant/operator, I 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 34- <br />32.5-120. C.RS.) as determined through a Board finding. <br />4. I understand that statements in the application are being made under penahy of perjury and that false statemerrts <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this "J t" day of ~a ~ c /./ , 2003 . <br />OURAY COUNTY ROAD 8 <br />BRIDGE DEPARTMENT If Corporation Attest (Seal) <br />ApplicanUOperator or Company Name <br />Signed: /~ <br />Title: ~B,a~ Su__2_FR~~ 7`Fz_ N _t"7_ r• JyT <br />State of Colorado ) <br />)ss <br />County of Ouray ) <br />The <br />by: <br />•'J~~ Y. • . ~Cti <br />p F~ ., d, <br />V fir*. ~ x •. d S <br />M} id. <br />J :~J'Fi.f. i rJi' <br />p "••.......•~ ~P <br />0 U'~l; <br />~ _..... <br />Signed: _~~ <br />- -Corporate Secretary or egliivaleM -`aFFFl I~,~~~ <br />Q__________, County Clerk or ep <br />was acknowledged before me this_I ~~e day of ~G r~ , 2003 <br />a sr'!a~ "of Ourav County Road 8 Bridge Department . <br />~~ (PLE/LSE, OD M07SpNTNR000N YOUR SFAL) <br />pUBL1C.'o~ <br />PQ ~,; <br />~'•••..••'~Q•a.~`r` (ual) My commission expires: ~'fa0/20~ <br />'•,9 ~ <br />N O T A I4 y; E (signature) <br />,.,..,,,~ Ic <br />ovloro9 SIGNATURES MUST BE IN BLUE INK <br />File: E 1 Our'ayCO 1 DallasGrav 1 112RmendAppl <br />