Laserfiche WebLink
<br />Ci <br />-~- <br />Certificatioa: <br />Ae 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)(f), C.R.S.; <br />3. As the applicant/operator, I do not have any extraction/exploration operations in the <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.S.) <br />ae 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 />-~t1 <br />Sioned and dated this day of <br />~) , ~i~tQ <br />If Corporation Attest (Seal) <br />~~~~~~'~ <br />Signed: <br />Corpora a Secretary or Equivalent <br />Town/City/County Clerk <br />State of 'C~Iau Q G~ ~~; ) <br />~~ ) es <br />County of ) <br />The foregoing i`nstrum`ent was acknowledged before me this~~ d111ay of~~~~11.+/~ 1~, <br />by ~ ~c'~"~ F~\, t~LJ~ ae Y P S ~ (~.Sl_i~" o~ ~a~ 6~Iz ~ ~P n l L[:Ct ft_~ <br />pp MqU <br />:'~ ~"' ~ io.r1. l (L~~Cl,llhv <br />_ NpTARY `•, _ 'f' Not~,~~h`'~'J iO~d~PIFES 31E)~9 <br />__ = Ny Commission expires: <br />PUBL~G <br />s?q QyB::: <br />~~~~o, <br />~~ SIGNATURES MUST BS IN BLUE INR <br />01/02/96 2673FC0.112 .. <br />Title: ~~.r_~P.n.-f <br />