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a ~ ` <br />8- <br />CertiGcatioo: <br />As art authorized repn:sentative of the applicant, I hereby certify that the operation described has met the minimum requirerncets of <br />the following terms and conditions: <br />1. To the best of my lmowledge, 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 afTected area have been identified in this application <br />(Section 34-32.5-1 IS(4}(e), C.R.S.). <br />2. No mining operation will be located on lards where such operations are prohibited by law <br />(Section 34-32.5-115(4xf), C.RS.; <br />3. As the applicanUoperator, I do not have atry extractiodexploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extractiarr of Construction Materials <br />(Section 34-32.5-120, C.RSJ as determined through a Board fading. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Ibis john dos deco approved by the Mined Land Reclamation Board parsaa»t W stQian 30.31.5-112,CRS, oJthe Colorado Land <br />Rtdamafion Aa jor Me Fxtraarion ajConsdvdioa Materials. Any aperation or modifunaion ojrhisjorm shall resadt in voiding any <br />permit Tuned on die abased or modijledjorm and sahled the operator to cease and desist orders and civil penahiesjor operatingx~hoal <br />a permbpwsaaM to section 3a-31.S-]23, CR.S <br />Signed and dated this _~__ day of ~cd a+~. an ~ 2 f~JL <br />/ <br />Kiowa County If Corporation Attest (Seal) <br />Applicant/Operator ar Comparry Name <br />Signed: <br />Title: Chairman <br />Signed: <br />Corporate Sec tary or Equivalent <br />Town/Ci County Clerk <br />State of COI.ORAI)D ) <br />} ss. <br />County of RIOWA ) <br />The foregoing instrument was acknowledged before me this 2t ar day of Fahrs.m n ~nnt; , <br />by Rodney Brown as Chairman of Riowa County <br />Debra A. Immer, Notary Public <br />State of Colorado <br />My Commission Expires 11/15/2009 <br />Notary Public <br />My Commission expires: <br />SIGNATURES MUST BE IN BLUE INK <br />November 15, 2009 <br />M:Miolshaeh5fumelCOn+huclim 112 doc (Appoved OS/11/2003) <br />