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i .• <br />-~- <br />Certification: <br />As ao authcrrued representative of the applipnt, I hereby certify that the operation described has met the minimum <br />requsem~ts of the following terms and conditions: <br />1. To the best of my knowledge, all significant, 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 nrining operation wi11 be located on lands where such operations are prohibited by law (Section <br />34-32.5-115(4)(fj, C.RS.; <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-i20, C.RS.) as determined through a Board finding. <br />4. I understand chat ~tat~++~+tc in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, CRS_ <br />Signed and dated this ~ ~ ~h day of ~ C~ewi ~o~e / . ~(Ia~ <br />If Corporation Attest (Seat) <br /> <br />.~ : - ``,= <br />Signed: ~ - <br />Corporate Secretary or Equivalent <br />Town/City/Cotmty Clerk <br />State of ~C~Q~O ) <br />Y ` ) ss <br />County of F2EYY1otYC ) <br />The fore,going incrn,n,rnt was acknowledged before me this _~ jQ kh day of \ Ef qtr` bC~2 2.©0'Z , <br />by .'1~~,ri ~ Q~, r as _~ :«~~c r,~ of a~~ - ~l:~E ~v~ ~4c,i- lYllt(~ tYY . <br />Jim <br />Notan• 1'ubiic <br />My Commission <br />SIGtiATL7tES NIIiST BE IiV BLUE Ii\TIi <br />nt:~~ahm;wfurmsMAmveecon uzm~ oaisrmo» <br />Title: ! /~P.S~~~ <br />