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=~- <br />Certificatioa: <br />As an authorized representative of the applicant, I hereby certify that the operation <br />described has met the minimum requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, 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)(£1, C.R.S.; <br />3. Rs the applicantloperator, I do not have any extraction/exploration operations in t~~e <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.3.) <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 />~( <br />Signed and dated this ZG day of r?!~f..~ ~~. <br />If Corporation Attest (Seal) <br />Signed: ~ £~Qn~. <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this ~ day of ~z /~, n~~, <br />by as lj.~. ~i;\ of ~Q~~~...-.. _.l_A_-._t-~'.~e.. <br />C~~ Notary ^~~ic1'~,~ <br />My Commission expires: 1 1 J~-~__ <br />SIGNATIIRES MIIST BE IN BLIIE INK <br />06/26/97 2823FC0.112 <br />J ) ss <br />County of "" ) <br />