Laserfiche WebLink
-~- <br />Certification: <br />As ao authcaized representative of the applicant, ]hereby ceatify that the operation descarbed has met the minimum <br />requir~ts of the following terms and conditions: <br />1. To the best of my knowledge, all signiScant, 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 identified in this application <br />(Section 34-32.5-115(4)(e), C.RS.). <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.RS.; <br />3. As the applicanUoperator, I do not have a~ 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.) as determined through a Board finding. <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 misdemeaaorpmsuant to Section 18-8-503, CRS. <br />Signed and dated this G day of V Ah/~i~2/ ~~3 . ~ ~ - ~~ <br />.~v~'- if Corporation Attest ($yalj--"< ^ _.~ ~" <br />=, ~ .. a3 <br />,' _ •~; <br />Signeds- <br />orporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of ~ l it f.' n o 1 <br />ss <br />Coarrtyof ~~~ih~ ~ ) y p <br />The f ving instrument was acknowledged beforeppme this d ~ day of ~ , ~, <br />by as ,.d'e~ _ ~~s~ra.. ofd - o <br />Co-v~.PEi` S,r~, <br />o~.~ .d~ <br />Note . Public =. "~ <br />•j% <br />+ti .. - <br />My Commission expires: 9 ~ f =0 3 <br />SIGiV.3TURES iVIUST BE IlY BLUE INI: <br />M:~uWmhafntrmM,o~tuetiw 112.AOC (10/13/7A01) <br />Title: //d t? C~ ~'//•n5.~0~~/ ' <br />