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• _y_ • <br /> Certification: <br /> an authorized 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(a) 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 /> 32.5-115(4) (e), C.R.S. ) . <br /> 2. No mining operation will be located on lands where such operations are prohibited by <br /> law (Section 34-32.5-115(4) (f) , C.R.S.; <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 34-32.5-120, C.R.S.) <br /> as determined through a Board finding. <br /> 4. 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 /> ' <br /> Signed and dated this n� day of - Ci7�7hr72 , <br /> n _ / <br /> �L-d l.fa>✓L�//i1J L,rnr c� U/{ '4Ti; L'���i7t�/ If Corporation Attest (Seal) <br /> A plicant/operator <br /> jned: �h i Signed: <br /> Corporate Secretary or Equivalent <br /> Title: /��� _ Town/City/County Clerk <br /> State of C_4?-C%Ado ) <br /> as <br /> County of Fle6�,4.7 A, r_ ) ( �- ` <br /> The foregoing instrument was acknowledged before me this ` day o£ - a_.t_ b45L 1 <br /> by�obQ,R� C- •S-�s�ek <J!i as _Mfi,A R�.P� of � C-A��norf L�y�_W <br /> �cmQa,,.1 <br /> Notary u lic <br /> My Commission expires: <br /> 0I/02/96 2MFCO.112 <br />