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1 •y <br />-6- <br />Certification: <br />As an authorized representative of the applicant, I hereby ce<tify that the operation destalbed bas met the minimum requirements <br />of the following terms and conditions: <br />All necessary approvals from local government have been applied far (Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made stnlcdue(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected area have bees identified in this application <br />(Section 34-32.5-115(4xe), C.RS.). (NOTE: For 110 operations, the affected area includes all lands delineated by the <br />permit boundary.) <br />3. No mining operaticn will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4xf), <br />C.RS.). <br />4. As the applicant/operator, I do not have any mining/prospecting operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Consuuctioa Materials (Section 34- <br />32.5-120, C.RS.). <br />5. I understand that statem~ts in the application are being made ands penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. <br />signed and dated this ~ nay of~,r-?il~' ~ D <br /> <br />' nhJn ~ of <br />signed: <br />Corporate secretary or Equivalent <br />Town/City/County Clerk <br />State of ~~ /O/'A~/o 1 <br />ss. <br />County of ~~,~yirr~C. ) <br />The foregoing instrument was aclmowledged before me this o? 7 ~ day of ~~~o,~~.e. , ~, by <br />RANDY L. SVIL"AI <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />MY Commission Expires SeD. 24, 2005 <br />M1mm~4erelve('orms\Cme4uaim110 (10/13!2001) <br />If corporation Attest (seal) <br /> <br />My commission expires: 96 Zy /os <br />SIGNATURES MUST BE IN BLUE INK <br />