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-8- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following teens and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) inexistence at the time <br />this application is filed, and located within 200 feet of the proposed affected area have been identitied in this application <br />(Section 34-32.5-1 15(4)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by law <br />(Section 34-32.5-115(4)(t), C.R.S.; <br />3. As the applicandoperator, I do not have any extractionlexploration 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 <br />(Section 34-32.5-120, C.R.S.) as determined through a Boazd finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />This form has been approved by the iYfined Land Reclamation $oard pursuant to section 34-32.5-112,0 R.S., of the Colorado Land <br />ReclamadouActfartheExiractianofConstrucHonMaterials. Any alteration ormadifrcationojtbisfarmshaRresultiuvotdingany <br />permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penattles for operating <br />without a permit pursuant to sectron 34-32.5-123, C.R S <br />Signed and dated this _~.~__ day of /VoVQM ~tr 2a~ ~ <br />~OLB&P.6 ~7RAV~L t LLC <br />Applicant/Opentor or Company Name <br />Signed: <br />Title: yes%~~P~ <br />State of ~ AU ) <br />ss. <br />Countyof~~i456 ) <br />"I'he foregoi/n~.g instrument was acknowledged before me th s ~~ day of __~yQ~>7 _~ _ /_, <br />_, bY ---'-`~1 !zQ~_____- as ~ e~ _ of _ ~ ~ i9 I, 7r21~P ~r LLC . <br />/l ~ <br />If Corporation Attest (Seal) <br />Signet: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />~~ P ? .~s <br />J~, <br />SIGPIATLJRES <br />SA9nnn~ham+vvrome`Cunstnxaiai N2.d,ro IApproveU OSi11/2W5) <br />NOTP <br />OF <br />~:~ <br />expires: <br />M'ta~gion tigAra Nawn~6w 7, 2009 <br />3100 Noah Ndada Avenw <br />tabpdo 59rinps, CO !0907 <br />