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<br /> <br />Certification: <br /> <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />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 this <br />application is filed, and located within 200 feet of the proposed aBected area have been identified in this application <br />(Section 34-32.5-1 IS(4)(e), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)0, <br />C.RS.; <br />3. As the applicanUoperator, I donor 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 Constriction Materials (Section <br />34-32.5-I20, C.R.S.) as determined through a Boazd 5nding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Y~ ^I <br />Signed and dated this ~ day of _ 1 V 0 t) PYrl~ e r , ~_.. `' <br />~ I I D b i IC Pf Pm t Y ~lrn e r c i-2, ~~ ~ e, <br />Apphcant/Ctperator or Company Name <br />Signed: y~ <br />Title: ~j~ //!(A . <br />If Corporation~AKest (SCI)`, r' <br />Signed: V <br />Co rate Secretary or Equivalent <br />State of ~0 ~t1/[A-D a ) <br />ss <br />County of ~QnYLt' ) <br />Town/City/County Clerk <br />The fore oin instrument was acknowled ed before me this St der of <br />g g g ~_ y ~/v ~ em bey 020 , <br />by ~fl'R-N ~. TJT7'LE as ~~S/S~y//f'.~C~e~rc~ti of /Yloh;~t P~PinlyCOn~rPl-2~ .~vc, <br />~~#JDA S. BACH <br />NOTARY PUBLIC <br />My Commission l=zpires 08/17/2004 <br />SIGNATURES MUST BE IN BLUE INK <br />