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REV102364
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REV102364
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Entry Properties
Last modified
8/25/2016 1:13:00 AM
Creation date
11/22/2007 12:53:56 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1981107
IBM Index Class Name
Revision
Doc Date
1/23/2001
Doc Name
CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
Type & Sequence
AM3
Media Type
D
Archive
No
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-~- <br />Certification: <br />As an authorized representative of the applicant, l hereby certify that the operntion described has met the minimum requirements <br />of the following terms and wnditions: <br />1. To the best of my knowledge, all significant, valuable and pemtanent man-made sttvcture(s) N existence at the time this <br />application is filed, and located within 200 fcet of the proposed affected area have been identified in this application <br />(Section 34-32.5-I 15(4)(e), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(£), <br />C.RS.; <br />3. As the applicant/operator, I donor have any extraction exploration operations in the State of Colorado cuaently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Conswction Materials (Section <br />34-32.5-120, C.RS.) as determined through a Boazd finding. <br />4. I understand that stat®ents in the application are being [Wade under penalty of perjury and that false statements made <br />herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and dated this ~~ day of ~G~u./.u1~ , ~~/ _ <br />ELB Stone. Inc <br />Applicant/Operntor or Company Name <br />Signed: <br />Title: Vice President <br />State of ~ ~~ Ycir>([~ ) <br />II ) ss <br />County of ~at..,~ A a Y ) <br />Corporate Secretary or Equivalent <br />Town/Ciry/County Clerl: <br />The foregoing instrument was acknowledged before me this _~2 ~ day of cT~n/ , ~, <br />by _~0.ll~c~ E ~r-~fui. as l~;~r ~vr S Of ELR SfA.J~e 7'„/G <br />---~~~/~ <br />Notary Public <br />My Commission expires: •y'- ~-2 -U 2 <br />~':~ <br />If Corporation AttiYt (Si-aY} <br />--. <br />', _ <br />Signed: ~~ilP~l~ ~ a4 <br />SIGNATURES MUST BE IN BLUE INK <br />
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