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<br />-~- <br />Certification• <br />As 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 significa-t, valuable and permanent man-made <br />structure(s) 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(9)(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 />9. 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 18-6-503, C.R.S. <br />Signed and dated this ~ day of~ ~9s £. <br />RD~ ~DVa.~ If Corporation Attest (Seal) <br />Applicant/Opez~ for or Company Name <br />~~" ~ /-~~ <br />Signed: Signedc~~-'~, . i r.: ~,' V~L,°/~/i f~ <br />,~// ~~ // Corporate Secretary or ,Equivalent <br />Title: ~i...~ He~rr.'ul1 ~i'ri~/ Town/City/County C/lerk <br />State of C G~%(Z/7c7~ <br />~ ss <br />County of ~ ) <br />~~, - <br />The foregloing~/ilnstrument was acknowledgeed before me t/his1 ~ day of~~ ~ ~~ ~, <br />by ) L `lV~~~~1~ as /U/L(_~ - /A//uJ7l~TC~ of ,~~Ct.7~< l,crLELL~II <br />Notary Public <br />G '{~ /,, <br />My Commission expires: ~'~l,~C~7~ <br />SIQATIIRES MCJST SE IN BLDE INR <br />04/25/97 2823FC0.112 <br />