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-~- <br />CerKiticatloa: <br />As an auWorized reptesentative of the applicant, I hereby artifythatihe operation described has met the minimum requirements <br />of the fallowing terms and conditions: <br />1. To the best of mylmowledge, all significant, valuable and permanent rrtan-rrrade structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed afioctod area have been identified in this application <br />(Section 34-32.5-115(4)(e), C.RS.). <br />2. No mitring operation will be located on lands where such operations are prohibited by law <br />(Section 34-32.5-1 IS(4)(f), C.R.S.; <br />3. As the applicanUoperator, I donor have any extractionlexploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Acclamation Act for the F,xttaction of Construction Materials <br />(Section 34-32.5-120, C.RS.) as determined through a Board finding. <br />4. I understand that statements in the application arc being made under penalty of perjury and that 61se statements <br />made herein are punishable as a Class 1 mrademeanor pursuant to Section I8-8-503, C.RS. <br />This form has baert approved by the Mtrtedlwtd ReelaAtwtart Board parsamrt ro secYtort 3t<-32.J-1I2,C.RS, ojlbsColorado Lmrd <br />RecGr,natbn jot the Evroctlon ojCanstraaion Maurlals. Any akswden or modiJlcatlon ojthts jorm shaA~P,{~.ipxklu"voiding any <br />pmnlt lssaed on the akered or arodiJled jorm and sabJtdlhe operator to cease and desLrt orderer and efeEf~pktT~kleaybrojidrottng <br />without a pererkparsaant to seetion 3I-3b,I23, GRS ` ~,~_ • ~. ` <br />=~ " ~- <br />Signedanddatedthis orh day of png„st 2004 ~ -- =-`~ <br />?~ - ~ . <br />,,-. .. <br />Continental Materials Corporation <br />ApplicenUOperator or Cor»panyName <br />Sired: 5..~ <br />Title: "`( ~ e E P K ES ~ Ot OJT <br />State of illinnia <br />53. <br />Countyof Cook ) <br />if Corporation Attest (Segl). ---- <br />,. <br />Signed: / `~~l~~J 1"'t'`ri1 <br />Corporate Secrehary oF$Qu4velent <br />The foregoing instrument was aclatowledgcd before me this 9th day of August 2004 <br />by Joseph J. Sum as Vice President / Of Continental Materials Cor <br />OFFlCIgI SEAL ~%~t-~ <br />ANNEMARIB 6 NUSEKABEL Notary Public <br />NOTAt1T PUBLiC, STATE OF E1MDIi <br />-sv coaarva>uow eta+nea:a~n:a~ g ,. a a-0~ <br />My Commission expires: <br />SIGNATURES MUST HE IN BLUE INK <br />M:~n.,e~ntoro.+coe,e~6on nr.a« (osooxoa> <br />