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-~- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence 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.R.S.). <br />2. No mining operation will be located on lands where such operations aze prohibited by law (Section <br />34-32.5-115(4)(f), C.R.S.; <br />3. As the applicantloperator, I do not have any extraction/exploration operations in the State of Colorado currently in <br />violation of [he provisions of the Colorado Land Reclamation Ac[ for the Extraction of Construction Materials (Section <br />34-32.5-120, C.R.S.) as determined through a Board fmding. <br />4. I understand that statements in the application aze being made under penalty of perjury and [hat false statements <br />made herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this 3'~ day of <br />MOUNTAIN AGGREGATES. INC. <br />Applicant/Operator or Company Name <br />Signed: <br />Title: <br />State of Colorc~l~ ) <br />1_1~r~ ss <br />County of ~/c~tcr~1R ) <br />Town/City/County Clerk <br />The forlegoing instrument was acknowledged before me this 3~ day of June 21b3 , <br />by Linclzt L- I~arq~ez. as 17reS~aent of Y~DUn~i~ ~4rrn~yT-nc. <br />3 <br />~~ ~~ i Not is <br />®O <br />~'••. <br />~~ ~~R. My Commission expires: /d 2 0~ <br />SIGNATURES MUST BE IN BLUE INK <br />If Corporation <br />~< - -> <br />c - ...~ - - <br />- ..., i- <br />T f y.~-~. <br />'~ ~~~~~~ ~ ~~ <br />Signed: <br />Corporate S or Equivalent <br />MU1IIi~BIX.IM-VPORMS12823C012.APP 10/l]/O] <br />