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<br />- 6 - <br />CertiScation: <br /> <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 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made structure(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 IS(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit <br />boundary.) <br />3. No mining operation will be located on lands wheae such operations are prohibited by law (Section 34-32.5-115(4xt), C.R.S.). <br />4. As dte applicant/operator, I 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 Construction Materials (Section 34-32.5-120, C.R.S.). <br />5, 1 understand that statements in the application are being made under penalty of perjury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S 1984. <br />~• • ~:, ', <br />Signed and dated this 19th day of <br />Logan County <br />Applicant/Operator <br />Signed: ~~// <br />Title: 4m~ .,,max-,.. <br />March <br />1999 _ . _:~~ , _ ~.. <br />~; , ,_. <br />~. .~ <br />If Corporation Attest (Seal) - ~ ~~''-' ' /c ~ ,' ,~~~. ~ <br />l„ ;, <br />_ -_~~~~. <br />Siged: ` <br />orporate S retary or Equivalent <br />TewnF6ity/County Clerk <br />State of Colorado <br />ss. <br />County of Logan ) <br />The foregoing instrument was acknowledged before me this 25th day of March , 1999 by <br />bT1Q ccr„m~nc~r as Commissioner of Board of Logan County <br />Commissioners <br />- r ~PRIA GARFiS 1n1 <br />~%Ap~l a~ <br />L}; N O T A R y': yr . Notary Public <br />• P U Q L t ` My Commission expires: Jan . 11, 2002 <br />9~F ~..~.~~~~~O~Q' SIGNATURES MUST BE IN BLUE INK <br />~F C0~ <br />M:Vv11NlSHAREIVSFORMSLR21COl0.APP 02/10/99 <br />