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2004-08-19_REVISION - M2003037 (3)
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2004-08-19_REVISION - M2003037 (3)
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Entry Properties
Last modified
6/15/2021 2:49:28 PM
Creation date
11/21/2007 3:00:19 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2003037
IBM Index Class Name
Revision
Doc Date
8/19/2004
Doc Name
112c Amend Appl
From
Haldorson and Sons Inc
To
DMG
Type & Sequence
AM1
Media Type
D
Archive
No
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.,.: , <br />-~- <br />Certification: <br />As an authorized representative of the applicant, I hereby certift~ that the operation described has mei the minimum <br />requirements 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 <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.SJ. <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.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 <br />34-32.5-120, C.RS J as determined through a Boazd fording. <br />4. I understand that statements in the application are 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 _~ day of ~h--, 20o y . <br />~a. /ears.... .R,d( S ... S7_ _ L=` . <br />ApplicanUOperator or Company Name <br /> <br />Title: ~~ <br />State of ~~/.~X'tJ <br />County of /~` <br />The foregoing instrument was acknowledged be e me this ~ day <br />/~G~,K ~. ~u as ./1~.c. <br />SIGNATURES MUST BE IN BLUE INK <br />If Corporation Attest (Seal) - <br />Signed: ' ~ <br />Corpora Secretary or Equivalent <br />Town/City/County Clerk <br />M:1min~chereWs(o'ms\Canstructian ~~~doc (10/1sYtCgl~ <br />
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