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REV95206
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REV95206
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Entry Properties
Last modified
8/25/2016 3:20:19 AM
Creation date
11/21/2007 11:47:13 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1976051
IBM Index Class Name
Revision
Doc Date
12/22/1997
Doc Name
CERTIFICATION
Type & Sequence
AM4
Media Type
D
Archive
No
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III III III IIIIIII III i~`U I~~^ i <br />999 DEC 2a _ 1997 ~//~/~/ ~s <br />Certification: " " -7~~ ta5/ <br />Division of ~.~.wnc~a.. ,-~~ -. <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 significant, 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 (4)(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 />4. 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 18-8-503, C.R.S. - <br />Signed and dated this ~ ~ day of ~iFR-C.N ~_. <br />ll~k,EZS ~.On"~-~~JGIICf~ t ~~i(,. ~~ Y~~wn If Corporation Attest (Seal) <br />Applicant/Operator or Company Name ~~~~~~~ <br />~ /t <br />Signed: 1 i 6 JY~~ Signed: ~' ~-~-d~.. <br />i i <br />Title: YKl-i~~ I-~lrrniA~~2~~iGe ~~Zc~(~D'~~ <br />State of ~ ~ ~ ~ RA ~~~ <br />County of ~ b L~ <br />ss <br />Co ate Secretary or Equivalent <br />Town/City/County Clerk <br />i H 1,( / <br />The foregoing i\nstrument was acknowledged before me this ? ' da1y of l - lfi 2 L ('" / <br />by ~~E3/ ~JI,~GKJ-S _- ~ OJ~CT fjN ~ of l~L~ci~E~S ~On15FRucr,o,~ <br />illy ~~-C-~ (~P~,J ~ ~ <br />Notary Publi ~7 <br />My Commission expires: ~( S ~S <br />SIGNATARBS MIIST SH IN SLIIB INK <br />ivC . <br />01/23/97 2823FC0.112 <br />'~ <br /> <br />
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