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.. <br />- 6 - <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.E-1 10(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made swcture(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-1 li(4)(e), C.R.S.). (NOTE: For l 10 operations, the affected azea includes all lands delineated bv_ the permit <br />boundary.) <br />3. No [Wining operation will be located on lands where such operations aze prohibited by law (Section 34-32.5-1 IS(4)(f), C.RS.). <br />4. As the applicandoperator, 1 do not have any mining/prospecting operations in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Conswction Materials (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements in the application aze being made under penalty of perjury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section I8-8-503, C.RS 1984. <br />Signed and dated this ~_ day of <br />~(,~. X _i <br />Wa chi nrtt•nn f'nnn}~_ f'harl PC T Kuntz, Foremanlf Corporation Attest (Seal) <br />ApplicandOperator <br />V <br />Signed: Signed: <br />Title: Road Foraman, Di ct i t <br />State of Colorado ) <br />ss. <br />COUntV Of Wachi nntnn ) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was ack~towledged before me this ~_ day of _~1 i Il~( //1~,~JCXJO , by <br />rlv~: ~ of _l A~C'~~4tiM-~sr. 1~1_,.},.1 - <br />J i'Y~ji ~,lnc`~C~~ <br />Notan Public <br />My Commission expires: -~- I ~c -C_~ <br />MUST BE IN BLUE INK <br />M:Vv1IMSI-L4RElVSFORMS~2821CO10.APP 06/?5/99 <br />