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/~~_ <br />~e v's bax <br />-6- ~NI-aaopo -090~0`p`"" <br />Certification: ~~OwkO~~~l PJfOS...xran+~ <br />As an authorized representative of the applicant, I hereby certify that the operation described has m~the m,n,m„m requirements <br />of the following teens and conditions: <br />911 necessary approvals from local government have been applied for (Section 34-32.3-110(1)(a)(viii). <br />2. To the best of my lalowledge, 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 azea have been identified in this application <br />(Section 34-32.5-115(4)(e), C.RS.). (NOTE: For 110 operations, the affected azea includes all lands delineated by the <br />permit boundarv.) <br />.. \TO mining operation will be located on lands where such operations aze prolubited b}- law (Section 34-32.`-11 i (4)f fj, <br />C.RS.). <br />4. As the applicanUoperator; I do not bare any minine/prospecting operations in the State of Colorado ctrrrently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34- <br />32.5-120, C.R.S.). <br />5. I understand that statements in the application aze being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pwsuant to Section 18-8-503, C.R.S. 1984. <br />Signed and dated this 13tH day of Atic~~.ST 2ooZ <br />L-OU><oNE~J $ROS. SZOA~ If Corporation Attest (Seal) <br />Applicant/Operator <br />Signed: cz=Z~/~`~~ C!~" (~ <br />Signed: <br />Corporate Secretary or Equivalent <br />Title: OWNER <br />State of Coo ~~ ~ u ) <br />ss. <br />County of ~ 1 ~~ ) <br />The foregoing instrument was acknowledged before me this ! 3 ~ <br />~-eona~d Lt~4[coneit as Orr„ <br />RECE9V/E® <br />AUG 152002 <br />Division of Minerals and Geology <br />Town/City/County Clerk <br />apO~ ,bY <br />12-s~-oa <br />SIGNATURES MUST BE IN BLUE INK <br />M~,shaze\vsfmmsM,onstraction110 (10/1 512 00 1) <br />