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<br />-7- <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 ofmy 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.SJ. <br />2. No mining operation will be located on lands where such operations are prohibited bylaw (Section <br />34-32.5-115(4)(f), C.RS.; <br />3. As the applicant%perator, I donot 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 finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and dated this /~ day of __ /r/~ , _~~~- <br />Oldcastle SW Group, Inc. dba ~ ~~ _ <br />United Companies of Mesa County If Corporation Attest (Seal) _ _ <br />Applicant/t?perator or Company Name _ , - <br />Signed: _~ Srgn ~ <br />Lowel y ock, Secretary <br />Corporate retary or Equivalent <br />Title: Craig Lamberty, President Town/City/County Clerk <br />State of Colorado 1 --~'"", <br />:.~^-, <br />County of Mesa 1 - - _ _ <br />The foregoing instrument was acknowledged before me this 4th day of Ma ~ 2004_: -b}•' <br />Craig Lamberty as President of nt~e~ ompam es°U~e~a-~ounty <br />~%O ~il~PSfP l~y1 ~~i GYGt, <br />NotarvPublic Genevieve M. Blecha <br />My Commission expires: Aori 1 4, 2007 <br />SIGNATURES MUST BE IN BLUE INK <br />M:\min~shereWsfomu\Coktruaion 112.doc QO/75/2001) <br />