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-~- <br />Certification: <br />As an authcaized representative of the applicant. I hereby ceAify that the operation described has m~ the minimum <br />requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanentman-made structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-115(4)(e), C.RS.). <br />2. No minurg operation will be located on lands where such operations are prohibited by law {Section <br />34-32.5-115(4xf), C.RS.; <br />3. As the applicanUoperator, I do not have a~ extraction/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 />34-32.5-120, C.RSJ as determined through a Board finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, CRS. <br />Signed and dated this ~ day of /~ebr+~G+,, , 2 O o 3 <br />S W /h.~arlo cJ ~ .C ~ C <br />Applicant/Operator or Company Name <br />Signed:/~G~'~/ ~32%f/~c(" <br />Title: ~2C~ <br />Stale of Colorado ~ <br />) 55 <br />Co,inh• of Arapahoe ~ <br />The foregoing inctnr~nrnt was acknowledged before me this <br />b~. Mark D. Campbell ~ Manager <br />VIRGINIA DUNCAN <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />My Commission Expires 413012005 <br />If Corporation Attest (Seal) <br />of ~ Meadow, IS.C <br />2003 <br />Notarti' ginia Duncan <br />4/30/2005 <br />My Co»»mssion expires: <br />SIGNP-TGRES MUST BE IN BLUE INK <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/Ciiy/County Clerk <br />19th ~,of February <br />M:~m~ Y~shae~v~orm~lComawtion rrzm~ rrarsrzom~ <br />