Laserfiche WebLink
• g <br />Crnifirarion <br />As an et+vsermod reprcsentativc of the applicant, I hereby certify Chas the opaxian daaibed hasmet the mmmnen rogtararsaus of <br />the fotlowtng toms acd caahurns <br />l To the bat of mY kraw lodge, all signifitant,valuable and ptswnetuman-made stNwae{s) N austmca at the lone dm <br />applitaston is 151ed, +nc) looted within 200 leer of the proposed afTetled stra have ban idenufied m this application <br />(Satiat 36.32 S•I13(4)(e),C.RS.). <br />2. No rtnolstg operutan will be lowest on lards where etteh operauats as prolubital by law <br />(Sation 34-32 S•l I S(4J(Q, C.R S , <br />3 As the +pplicanUopaalor, l do not have esry atnctwn/e:ploruian operuiau m the Sute oC Co;cxado anenty m <br />violation of the prvvisicros of the Colorado lend Rcclartutian Act fa the F~trscurn of Construction Muenals <br />(Section 34.32.3.120, C.RS.) as dotmninod Urtwgh ^ Howl firdutg, <br />4, I undetslud ttuLL staLerrlatla in the sppliGlion arc being made tutder penalty of perjury and Ihu faLu statema+b made <br />haeut arc pwishabk es a Class I nusdarrcarar ptasuant a Satim i B-g•SU3, C.RS <br />71ah Joan Mesa ban a0prws/ 1 y a[v A3Ged Lawd Rec6aaatlon eeu! prnnanr ro utoow .N-32, i112,CRS, of r6r Colwadn l.m~! <br />Recfawution Adjer de Emactiw ojConroralun MaueioCt Aq abrealon a aao/~iraetan aja/u Jain rbatl ra.d is ro(uWrj any <br />permit tuaalon be dad or noelArlJarn arleabJecftbe ap~ar ao taw err//eaM ar/rtr o/ ri.:[perd[eJo. oy+~q wi~rt <br />a pesn~df pvvawt av aedarr 31-32 i/23, C RS ' <br />Sig:sed aad dated Ocs 7 nd -day of ~K --- U ~ I <br />• ~~)~~~~ n a r, oat ouncy <br />J~'S~L~s, + ~~/~~~~_ t ^~~)~JI'1) Co alonare <br />Applicara! of Company Name Itlt i~/~S// / 02 / 2007 <br />1 Gq <br />®LIJr~~1; C k orEgws t <br />Titk: Cowis+City/Caauy Clerk <br />0 o placement <br />stueer ('r~t~:~ <br />~~~~ '^ ounty Clerk <br />~ forcgang i s r l y oC y 1 • ,~~R, C <br />l : + of •. ! <br />J' r~~p7~~y~ tt~ <br />Nourv '•,' t+~~'~' <br />MyCommsssi •~• --- -- <br />utroa.irrnm ttwesa Obt!!mN <br />S[GNATURFS MUST B~ tN BLUF. [`!K <br />i <br />