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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 terns 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 affected area have been identified in this application <br /> (Section 34-32.5-115(4)(e), C.R.S.). <br /> 2. No mining operation will be located on lands where such operations are prohibited by law(Section 34-32.5-1 15(4)(f), <br /> C.R.S.; <br /> 3. As the applicant/operator, I do not 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 Construction Materials (Section <br /> 34-32.5-120,C.R.S.) as determined through a Board finding. <br /> 4. I understand that statements in the application are being made under penalty of pajury and that false statements made <br /> herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503,CA-S. <br /> Signed and dated this 4k, day of <br /> �T^b �`r^B gDR� DF�Mt4,SStat�Edis If Corporation Attest�Seal) <br /> Applicant/Operator or Company Name <br /> Sign Signed: / <br /> Corporate Secretary or Eq ,iicnt <br /> Title:- T.e�/County Clerk <br /> State of b)%_O A,4e'n ) <br /> ss <br /> County of VRt= tcl,0T ) <br /> The•foregoing:iststnrment was acknowledged before me this day off, <br /> ,bv=f 5 A4tr_ as CPf 44AAI of N <br /> My Commission expires: 6-XV <br /> SIGNATURES MUST BE IN BLUE INK <br />