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<br /> <br />c- <br />Certification: <br />As an authorized representative of the applicant, L hereby certify that the operation described has met the minimum requirements <br />of the following tetras and conditions: <br />1. All necessary approvals from local government have been applied for (Section 34-32.5-1 l0(1)(a)(viii). <br />2. 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 34-32.5-I 15(4)(e), C.RS.). (NOTE: For l 10 operations, the affected area includes all lands delineated by the <br />permit boundary) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.R.S.). <br />4. As the applicant/operator, I do not have any mining/prospecting operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation AM for the Extraction of Construction Materials (Section 34- <br />32.5-120, C.RS.). <br />5. I understand that statements in the application are being made under penalty of per~un and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. ~p~y ~1jV0f~` <br />,,y o <br />Signed and dated this ~7 I ~` day of Ll.~y~f- ysrp <br />(1 y <br />~412~U W1'fE ~~41_ o <br />/~ 7~ b ,z <br />_IYA~R-V /U wl /~ b-72t-C If Co r~io`p Attest (Seal) x,~ <br />AppGcandOperator Sob ~, `~ <br />•Py ~' <br />~~ ~ ° v~ <br />Signed: ,..~~~~i~%'~~%G.c~ -~".. er.~~. Sigted: <br />'~ -7~ ~r •" ~~ ~~' ~ ~rporate Secretary or Equivalent <br />Title: r DAL, ; Town/City/County Clerk <br />`. pINDF-~~ i ~ <br />rn~,. :;Qr <br />State of ~L.02F1-Do ) 9~•...........•:~O <br />ss. OF CO <br />County of ~l-_5/~ ) <br />/T"~he foregoing instrument was acknowledged before me this 17 ~ day of /~ Lt-~-~" ~{j0 I , by <br />C~/.f-fir ~,tJ/JL~72-C~' as~{ ~51(~LIU~ ofca~l iJDLIe-LL~~SrR,ucT1,NJIN~ <br />otary biic <br />My Commission expires: X01 <br />SIGNATURES MUST BE IN BLUE INK <br />