Laserfiche WebLink
7- <br />Certification: <br />As an authorized representative of the applicant, t hereby certify that the operation described has met the minimum requirements of the <br />following teens and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.5-1 t0(I)(a)(VIII). <br />2. "fo the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-I 15(4)(ej, C.R,S.). (NOTE: For 110 operations, the affected area includes all (ands delineated by the permit <br />boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.R.S.). <br />4. As the applicanUopera[or, f do nut have any mining/exploration operations in the Slate ofColorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction ofConshuction Materials (Section 34-32.5-120, C.R.S J. <br />5. I understand that statements in the application are being made under penalty of perjury and that false statetents made herein <br />are punishable as a Class 1 rttisdettteanor pursuant to Section 1 B-8-503, C.RS. 1984. <br />This form has been approved by rh¢ Mined Land Reclamation Raard pursuant to section 34-32.5-l1 QGRS:, ofthe Colorado Land <br />RedaroaHon Aci for the F.xtradfon of Construction Materials. Any alteration ar modlftcation of this form shot! result in voiding <br />ony permit issued on the altered or modifred jorm and subject the operator to cease aad desist orders and civil penakies jor <br />operating withoat a permit pursuant to section 34-31.5-723, C.RS. <br />Signed and dated this -3~ ~~^ day of ~\\}l kC~ ~Z.c7 O ~ <br />J P+~k ~ $ f f l ~t~ [f Corporation Attest (Seal) <br />Applie or <br />Signed _____~ <br />Title: DwnEk - <br />) <br />Slate of <br />ss. <br />County of __) <br />'Che foregoing instmment was acknowledged before me this <br />-' by - <br />as <br />of <br />Jennifer ~otary Pubes -y-- ~`p~,~, <br />RU(ItIiIC My Commission expires: L1t~P ~t ~l,l) l -_. <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/CityiCounty Clerk <br />day of <br />SI4NAT-~~'~ISF.UE INK <br />M:4nin`sh:ire:vetunn>':Con>Iruclimil l0 (AppnrvW O511 IR005) <br />