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N • <br />- 6 - <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. All necessary approvals from local goverrLment have been applied for <br />(Section 34-32.5-110(1)(a)(viii). <br />2. 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.). (NOTE: Por 110 operations, the affected area includes all lands <br />delineated by the permit boundary.) <br />3. 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 />4. As the applicant/operator, I do not have any mining/prospecting 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, <br />C.R.S.). <br />5. 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 1984. <br />Signed and dated this ~~ ~/day of /`' ~/v ,i ~,r•'" ~~ T <br />i°4~ r~rC.~.d ~ 1 <br />Applicant <br />Signed: <br />1J /J/~ i <br />Title: .5`57- f/'/~1~/r~~!~~'~'' <br />r / <br />state of COLD R (1-Q O ) <br />:~s <br />;4 ^,•2g~,~If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />County of M ~ s A' ) <br />The foregoing instrument was acknowledged before me this ,day of ~~+-2u.4'U. ~, <br />by \tR-{'I.-Yl ~L.b~~'2~1'YI.C2~ as ~~.s~/~ ~/Y.G7-~.~ Z'Vl~iof ~~, ~U <br />u' <br />/7 ~ /. ~,. <br />00 - C,GZ~Z'rn~.~ 1, L~C~:% <br />~ Y ~d~ ~ Notary PubUlic <br />~ V ~ My Commission expires: <br />g = ~~ ; <br />~~ <br />SIGNATURES MUST HE IN SLUE IHIC <br />04/25/97 2821FC0.110 <br />