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S° <br />-8- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimtmt recnriremmts of <br />the following terms and camditions: <br />1. To the best ofmy knowledge, all significant, valuableand permaneatman-made stmchue(s) inexistence at the time this <br />application is film, and located within 200 feet of the proposed affected area have been identified in this application <br />{Sxtion 3432.5-115(4xe), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law <br />(Sectie~n 3432.5-115(4xf), C.RS.; <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 pmvisions of the Colorado Land Reclamation Act for the Extraction of Conshuction Material4 <br />(Section 3432.5-120, C.RS.) as determined through a Board finding. <br />4. I tmdastand that statements in the application are being made under penalty of perj~ny and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Sectien 18-8-503, C.RS. <br />Tkb jorrn has bun approved by the Asurad Laid Ree4unadon Board pwrsuaAt to section 34-3a.S-113,G1LS, ojlbe Colorado Lwrd <br />Radmraafioa Actjov ate Exbadan ajConatraation Ma?erlalx Any altobaton or modi,~toa ojthLjorm shell raudt be voidbeg any <br />paarit tunsd on the aBered or modrfiadjorin and subjaxthe opsratorto awes and duiatordsrs and amrTpatgEdssjor apeatbrgxdhout <br />a pmnRparsrwM to ssdion 34-3?.5-123, GRS , ; ~ `l~J `; U, !` (J , . <br />J <br />Signed dated this 2 2 day of 2.001„ ? ; ~ ~ n '*' <br />~~u~ a. <br />~' ~' tit .,;> <br />. C - <br />IfCorporation Attest',(5etal), . - ,, ; <br />Applicant/Operatotor a~Name '_.,~~ ~ .:`"-.,.; <br />Signed: ~~y~~ FC~T signed: /tlo~av~r~."Cl,~~o~X <br />Corporate secretary ~ Equivalent <br />Titie_ C~;vmc~l a~ ~c~4r~ Town/Ci County Clerk <br />State of Calorac~e ) <br />99. <br />County ofytact;..g-l~^ 1 <br />The foregoing inshtiment was aelmowledged before me this a~. day of o Aq zcao6 <br />by Dame). FeV - ~`~_as G41w~r.,~ah o. Of S~i~ha~o.~ Le b.~~ <br />1 Notary Public <br />--~-' 1 !d <br />°~ ~ ~, y0~~o~ My commission expQes: Z-!/-ZOO7 <br />SIGNATURES MUST BE IN BLUE INK <br />t.+w~.n~~+~r.~a~ i iza« (nppoved osn moos) <br />