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-G- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.5-I 10(I)(a)(viii). <br />2. To the best of my knowledge; all significant, valuable and permanent man-made structure(s) m existence at the time <br />this application is filed, and located within 200 feet of the proposed affected azea have been identified m this application <br />(Section 34-32.5-115(4)(e), C.RS.). (NOTE: For 110 operations, the affected azea includes all lands delineated by the <br />permit boundary.) <br />3. No mining operation will be located on lands where such operations aze prohibited by law (Section 34325-115(4)(f), <br />C.RS.). <br />4. As the appficanUoperator, I do not have any mining/prospecting operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Constnrction Materials (Section 34- <br />32.5-120, C.RS.). <br />5. I understand that statements in the apphcation are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. <br />Signed and dated this ~=~ day of 1~1 x00 I <br />~l c.clnlve.~ ('ons>~4~~-ton If Corporation Attest (Seal) <br />ApplicanUCtperator <br />Signed: `~.-•cP.~7 ~~.-- ~ Signed: <br />Corporate Secretary or Equivalent <br />Title: (~~,t9~ Town/City/County Clerk <br />State of ~~rr~o <br />ss. <br />County of ~Q.uit ac, ) <br />_ ~ <br />The foregoing instrument was acknowledged before me this ~_ day of , aCb ~, by <br />•~ ~r - y` ~'~~ ~ as .-(r~ t,.~ ~~ r' r of ~r ~ 1 d~2t ~ ~rS7-rrnc`f7.~ <br />~~ <br />~~.,. _ <br />3 ,,: - _ <br />" • ~-._ - - <br />' ~`;. --~ - o ary Public <br />• ~ My Commission expires: d 6 ~r <br />SIGNATURES MUST BE IN BLUE INK <br />