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-~- <br />Certification: <br />As an authorized representative of the apgi9,Cant, I hereby certify that the operation <br />described has met the minimum requireme7yt of the following tercoe and conditions: <br />1. To the beet of my knowledge, aleignificant, 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.). <br />2. 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 />3. As the applicant/operator, I do not have any extractionJexploration 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, C.R.S.) <br />as determined through a Board finding. <br />4. 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. <br />Signed and dated this ~ day of / •~~ ~ [ `b . <br />Southwest Rea%;•-Mix, Inc. <br />Applicant/Operator <br />signed: <br />oy am art <br />Title: Consultant and Agent <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of Col <br />1 ss <br />County of Pueblo ) <br />The foregoing instrument was acknowledged before me this ~DI'7iay of ~~ - ~ 4 ~? <br />'-pp //11 ~~ ~ ~orss4:wcsf /~1' ~7.~~~,y~ <br />by ~~~/~ ~ b~CA//~~Cl as C..Q.~~Sr~~(.~ ~ 'F>~.a1f of ~~- ~,x(~~"'(, <br />DEG. ~ 1 q4 $ _ / ! ~, <br />Notary Pub is <br />~. _. riy Commission expires: /7.01-`)Q) <br />_ '~ <br />01/Di`/§~. 7E]3FCO,li2~- .~ <br />