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-~- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation descrbed has met the atinimum <br />requirements of the following tenors and conditions: <br />1. To the best of ttry knowledge, all significant, valuable and permanentman-made sttuctute(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.RS.). <br />2. No mining operation will be located on lands where suciti operations are prohibited by law (Section <br />34-32.5-115(4)(f), C.RS.; <br />3. As the applicanVoperator, 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 />34-32.5-120, C.RS.) as determined through a Board fording. <br />4. I ~mdastmmd that statements in the application are being made ceder penalty of perjury and that false statements <br />made herein ate punishable as a Class 1 misde~or pursuant to Section 18-8-503, CRS. <br />Signed and dated this~'~ day of ~i ~ OU-'~ <br />~I`2~1~YlYle. COt~~i"a <br />App cant/Operator ~ mry Name <br />If Corporation Attest {Seal) <br />Signe~ 1 ~/ . oeu <br />//~ ~ ~ 0 11 ~ <br />Title: C~Olhl~+l r-tQ.M1Y~1~T~~T(]r <br />State o / ~>-,~-_.~-~- ~ 1 <br />) SS <br />County of <br />The g ms ent w-as aclmowledged <br />by as <br />Signed: ~~ ~-~;`, ~ ~ <br />Corporate Secretary or Equivalent <br />-~pe~eeelEitq/County Clerk <br />pJBcx~C?~ Eo poSio <br />Gaffs,..-.~. <br />Notary Pu <br />My Commission expires: ~~~A'd ~ <br />SIGNATURES MUST BE IN BLUE INK <br />td:~~,meuzaa ryaurtaop <br />