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~` ~ • • R~eiv~t <br />' - ~ - SEP 1 9 2000 <br />~~rd <br />Certification: D~~nol~ai~8~a1 <br />As an authorized representa[ive of [he applicant, (hereby certify chat the aperadan describzd has mat thz minimum mil' <br />' requirements of the followin; terms and condi[ions: <br />I. To the best of my knowledge. all sisniticant, valuable and permanent man-made struc;ure(;) in exis[ence at thz [imz <br />' this application is tiled, and located within 200 fezt of the proposed affzc;zd area have been idzn[itizd in this application <br />(Section 3~1-32.5-I IS(~)(e), C.R.S.). <br />' 2. No mining operation will be located on lands where such operations are prohibited by law (Section <br />34-325-I 15(g)(f), C.R.S.; <br />3. As the applicandoperator, I do not have any extraaion/exploration operations in the State of Colorado currently in <br />' violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.~-120, C.RS.) as determined through a Board finding. <br /> <br /> <br />lJ <br /> <br /> <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made harem are punishable as a Class 1 misdemeanor pursuant to Section 13-8-503, C.RS. <br />Signed and dated this P ~ day of ~ ~- ~ -~ O D D <br />Art Beavers <br />If Corporation Attest (Sea!) <br />Applicanr/Operator or Company Name <br />Signed: .G~ *_) -EG~•K-w <br />Signed:: <br />Corporate Secretary or Equivalent <br />' Title: Pr/e~sident Town/City/CountvClertc <br />' State of / ,~ ) <br />ss <br />County of ,~ )r ~re- ) <br />t The foregoing instrument was acknowledged before me this ~ day of ~~ Q ~~0 <br />by ~,~ >~ov.l~cti.,, as.~ ~ of .rt- of t ~ Lco.C~ ct..kQ <br />~~RY P~e~i a. ~~-•~ e.~ <br />' KAY ~ Notary' ublic <br />' ~.~t '~ My Commission expires: ~~- ~ ~OOs <br />' SIGYATURES iv1UST BE IY BLUE IYK <br />N.ltIrMSHApE1V5FORV612J_:COI•_-.APP 4JIMA <br />