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~~- ~ ~ ~~~ <br />0 9 ~ <br />Certification: °~ p~ /L <br />As an authorized representative of the applicant, I hereby certify that the operation described has and the minim( ~ ~® <br />requirements of the following terms and conditions: '~ <br />°~`fl <br />1. To the best of my knowledge, all signiEcant, valuable and permanent man-made stmcture(s) in existence atfhe time <br />this application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-115{4){e), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section <br />34-32.5-115(4)(f), C.RS.; <br />3. As the applicanUoperator, I donot have any extraction/exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.5-120, C.RSJ as detemuned through a Board fording. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanorpursuant to Section 18-$-503, CRS. <br />Signed and dated this `7 ' day of ~,1(! (S//YN ~lL.~ ,~~. <br />DenJ~r (3r:~K Co. C(~ <br />rte pus i ~n rr vl . s <br />Applicant/Operator or Company Name <br />If Corporation Attest (Seal) <br />Signed: ~~ ~~!'~7 <br />~ ~ ,p 'y~~ <br />Title: ~~u/K.r /~(Q~'1Li~1E~h/ <br />State of ~'~C~,e~o <br />> ss <br />County of __ 1 <br />Signed: ~ L <br />Corporate Secretary or quivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this ~r ,_~ day of CQ/ri( ,Gi~, <br />bc~~ t~~ ~ c c1 U. as ~~A~tj ~`V1Q~w~~_ of ~ <br />-~ IJenver ~jr~cK Ca. ;~ ~ , <br />, ` '=. _ <br />o•,~ '~~ <br />_ ~.: <br />Notary Public ~•` '~'~ r <br />My Commission expue5'r ~~ 2%4!2008 "`• <br />SIGNATURES ivIUST BE IN BLUE INI: <br />M~midn6are\vsform~tl'.~actian 112dac ((0/13/1001) <br />