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• <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 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. 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 ae a Clasa 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this ~~ day of ~7'7QA/Ufl ~, ~~. <br />The Denver Brick Company <br />Applicant/Operator or Company Name <br />Signed: <br />Title: President <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate cretary ar Equivalent <br />Town/City/County Clerk <br />State of Cv[..~~AAo <br />ss <br />County of b0U6L~ ) <br />The foregoing instrument was acknowle(d~ged before me this ~ day of1~~YI N U A /~ 7~(// <br />by Ah+) IQ E.rJ/YJ~ FEZ JQae Pl1,es+ b~~ of T1FF~ Jf3AlV~. R( ~--~'~/ <br />i 10.x:, (~.at,•YYllpl~ - <br />~~ Notary Fublid = _ <br />My Commission exp~~!"'~l~Q ~~--~~' 28,1~~ <br />_. ~ <br />. . <br />SIGNATURES MUST SS IN BLUE INR <br />01/02/96 2673FC0.112 <br />