2004-02-24_REVISION - M1977153 ‎(6)‎

• Permit No: M1977153
• IBM Index Class Name: Revision
• Doc Date: 2/24/2004
• Doc Name: Amendment Application
• From: Denver Water Department
• To: DMG
• Type & Sequence: AM2
• Media Type: D
• Archive: No

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Certification:
As an authorized representative of the applicant, I hereby certify that the operation described has met the min~mnm
requirements of the following terms and conditions:
1. To the best of ary lmowledge, all significant, valuable and permanent man-made structure(s) in existence at the time
this application is filed, and located within 200 feet of the proposed affected area have been identified in this application
(Section 34-32.5-I15(4xe), C.R.S.).
2. No mining operation will be located on lands where such operations are prohibited bylaw (Section
34-32.5-115(4)(f), C.RS.;
3. As the applicant/operator, I do not have arty extraction/exploration operations in the State of Colorado currently in
violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section
34-32.5-120, C.RSJ as determined through a Board finding.
4. I understand that statements ire the application are being made under penalty of perjury and that false statements
made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS.
Signed and dated this 23 day of February 2004
City and County of Denver, Acting by and through
its Board of Water Co¢cnissioners
ApplicanUOperator or Company Name
If Corporation Attest (Seal)
Signed: ` _ _ '~'~~~ Signed:
Corporate Secretary or Equivalent
Title:
Attorney
State of Colorado )
ss.
County of Denver
Town/City/County Clerl:
The foregoing instrument was aclmowledged before me this 23 day of February 2004 by
Michael L. Walker ~ Attorney cdx for City and County of Denver, .
Acting by an its Board of Water Connnissioners
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,S•~ATE OF GGv y Commission expires:
SIGNATURES MUST BE IN BLUE INK
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