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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 of the following terms and conditions: <br />1. To the best of my Imowledge, all significant, valuable and pemtarrent 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 34-32.5-115(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)(f), C.RS.; <br />3. As the applicant/operator, I do not have a~ 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.RS.) as determined through a Board finding. <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.RS. <br />Signed and dated this 2 2nd day of Ju 2 0 0 4 <br />Nigh pia;ns Sand And Gravel, LLC <br />Applicant/Operator or Company Name <br />If Corporation Attest (Seal) <br />Signed: ,~~/ /6 l//~ <br />Robert C. Pittin on, Jr. <br />Title: Manager <br />State of COLORADO ) <br />ss. <br />County of LARIMER ~ <br />The foregoing instrument was acknowledged before me this 2 2nd <br />Robert C. Pittington, ~'. Manager <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />day of July 2004 by <br />of High Plains Sand And Gravel, <br />Votary <br />blyCommissionexpires: January 19, 2005 <br />SIGNATURES MUST BE IN BLUE INK <br />M•~;,,~a~Kr~~cmm~m~ iia.a« oaunooi) <br />