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-~- <br />Certification: <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 beet of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application ie 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. Ae 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. Z understand that statements in the, application are being made under penalty of <br />perjury and that false statements made herein are punishable ae a Class 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S. <br />I~ <br />Sicned and dated this <br />day of <br />If Corporation Attest <br />1'~ _ <br />=~~~- -- <br />? ~:: . <br />`~(/Seal) <br />Signed: ~''- W ~~ <br />Corpora a Secretary or Equivalent <br />Town/City/County Clerk <br />State of .~I~!(Q dl7 ) <br />ss <br />County of ~~ ~ ) <br />The foregoing i`nstrum`ent was acknowledged before me thie~~ day of~U~1~C.~ ,,~, <br />by N)(~CtW~ {~~. t~ a~~51(9.~r..~- of l C1,. ~ Y QWL <br />~o~„~wnw~~uo.,, <br />,~~~PP. MqV .O ', /~ <br />9, f `~^yA1~I',`•` <br />_ ,' Np'fARY `••. _ ~f_" N~t~C(~h~~~ONEXPIRES 3~6J99 <br />' = My Commission expires: <br />•~` PUBL~G ~' <br />s~ ...........~~:' <br />9~OF C0~ <br />SIGNATURES HOST BS IN SLUE INR <br />\ J..I.Y 1~ , ~ 1~. <br />01/02/96 2ffi3FC0.112 ~~ <br />Title: ~~P.n.-F. <br />