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PERMFILE100239
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PERMFILE100239
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Entry Properties
Last modified
8/24/2016 9:55:03 PM
Creation date
11/24/2007 6:54:15 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2004084
IBM Index Class Name
Permit File
Doc Date
12/29/2004
Doc Name
112c Appl
From
Benson Brothers
To
DMG
Media Type
D
Archive
No
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-~- <br />Certification; <br />As an suthorizod representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 3432.5-115(4xe), C.R.S.). <br />2. No mining operation will be located on (ands where such operations are prohibited by law (Section <br />3432.5-I 15(4xf), C.RS.; <br />3. As the applicant/operator, I do not 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 />3432.5-120, C.R.S.) as determined through a Board finding. <br />Q. I understand that statements in the application are being made ands penahy of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and dated this ~ 5~ day of ~~ ober DD`~ . <br />Brothers <br />Signed: <br />Title: ~%.~ /~LG ~ r . <br />5tateof IDY7.f>~fJ ) <br />)~ <br />County of ~e ~'~. ) <br />The foregoing instrument was acknowledged before mama <br />by'~~uYt/~~PnSOn~ as,~~B <br />~wiskf~~. ~enSon ~P <br />pP <br />CN <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk ' <br />day of 1!/GT"D~' a~1 ~- <br />No ~c <br />My Commission expires: ~~' ~7 -ddd~ <br />SIGNATURES MUST BE 1N BLUE INK <br />M:umrsexae~wsracnsusxxv~:xer aonmss <br />
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