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REV89646
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REV89646
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Entry Properties
Last modified
8/25/2016 3:11:31 AM
Creation date
11/21/2007 10:53:53 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1978051
IBM Index Class Name
Revision
Doc Date
2/18/2000
Doc Name
CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
Type & Sequence
AM1
Media Type
D
Archive
No
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<br />-r- <br />Certification: <br />As an authorized representative of the applicant, 1 hereby certify that the operation described has met the minimum requirements of the <br />Following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 3a-3'_.~-I 10(I)(a)(viii). <br />2. 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.E-I I ~(4)(e), C.R.S.). (NOTE: For 110 operations. the affected area includes all lands delineated by the permit <br />boundary.) <br />No mining operation will be locoed on lands whets such operations are prohibi[ed by law (Section 34-32.5-I 1 ~(4)(f), C.R.S.). <br />4. As the applicandoperator, I do not have any mininglprospectingoperatlons in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements in the application aze being made under penalty of perjury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S 1984. <br />Signed and dated this <br />14th <br />Lincoln County <br />Applicant/Opetator <br />February <br />day of <br />Signed:'- ~~ ,o~,~ <br />Title: Chairman/Lincoln County Commissioners <br />State of Colorado ) <br />ss. <br />County of Lincoln ) <br />19th <br />The foregoing instrument was acknowledged before me this <br />F. Euoene Vick Chairman <br />as <br />2000 <br />[f Corporation Attest (Seal) <br /> <br />Corporate Secretary or Equivalent <br />Town/Ci County Clerk <br />February 2000 <br />day of by <br />Lincoln Co. Commassioner~ <br />of <br />`~ <br />Notary Public <br />My Commission expires: ~+ ~`~ at~~ <br />SIGNATURES MUST BE IN BLUE INK <br />M.t~(Lr'~Si-4t RE`.VSFORSIS',28_ICOIU.APP U3/IU/~ <br />
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