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• -7- • <br /> f,ertifiealiea: <br /> As an authorised representative of the applicant, I hereby certify that the operation <br /> described has met the minimum requirements of the following terms and conditions: <br /> 1. To the best of my knowledge, all significant, valuable and permanent man-made <br /> structure(s) in existence at the time this application is filed, and located within 200 <br /> feet of the proposed affected area have been identified in this application (Section 34- <br /> 32.S-11S(4) (e), C.R.E.). <br /> 2. ■o mining operation will be located on lands where such operations are prohibited by <br /> law (&action 34-32.S-11S(4)(f), C.R.&.f <br /> 3. As the applicant/operator, I do not have any extraction/exploration operations in the <br /> State of Colorado currently in violation of the provisions of the Colorado Land <br /> Reclamation Act for the Extraction of Construction Materials (Section 34-32.S-120, C.R.S.) <br /> as determined through a Board finding. <br /> •. I understand that statements in the application are being made under penalty of <br /> perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br /> pursuant to Section 18-8-503, C.R.S. <br /> t , <br /> Signed and dated this -.&o <br /> If Corporation Attest (i al; •,l� <br /> Applicant/0 <br /> rato Company Bame ) <br /> Signed: Signads <br /> 004orite Becratary or Equivalent <br /> Sitlet tc - J Sown/City/County Clerk <br /> State of <br /> County of +T^ ) <br /> She foregoing instrument was acknowledged before me this day of J J O <br /> .I <br /> by CAL 4 X ki as V;fl-Cll I b id Ilif of <br /> f1 Aw+ l!I'] I <br /> •�e� Rotary Public <br /> My Coo®&salon atrpiremt �h�►9i/1�t�e;,�Nf� <br /> &Im011VRSS NOES BE IN lam RIM <br /> h/@/% ImFCO.IU <br />