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<br />-~- <br />Certification: <br /> <br />As an authorized representative of the applicant I hereby certifc that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />All necessary' approvals Gom local eovernment haee been applied for (Sz:uon =-1-=2.~-l 10(t)(a)(~ iii). <br />2. To the best of my knowlcd,e, all si~mificant, valuable and permanent man-made structure(s) in existence at the time this <br />application is tiled- and located within 200 feet of the proposed affected area hate been identified in dais applicauon <br />(Section 3~-=2.d-I IS(d)(e). C.R.S.). (NOTE: Fur l10 operations, the affected area includes all lands delineated by the permit <br />boundan.) <br />No mining operation Hill be located on lands where such operations are prohibited b}' law (Section 34-325-1 l~(4)(f), C.R.S.). <br />4. As the applicant/operator, [ do not have any minine/prospectingoperotions in the Slate of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 3~f-32 5-120, C.R.S.). <br />=. [understand that statements in the application are being made under penalt}• of perjure and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS 1934. <br />~3- ~ ~/ <br />Signed and dated this j ~ da} of rN_GCJ~~ o20C~0 , <br />LOuko tJ E nl BRos. 5'soN t If Corporation Attest (Seal) <br />ApplicandOperator <br />Signed: ~ ~ Signed: <br />Title: ~~~'Llil~ <br />State of C..QUz~Q-d ) <br />~~ //~~ ) ss. <br />County of Qa'u-~'Ri-L ) <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />Z~- <br />The foregoing instrument was ackmowledged before me this ) 7 dac of ~aOC~ , by <br />I.Fb,UR121J /~DUKp~frt~ as Of-uNF,~ ~-o~ ttJ:mN~N ~,ed7i:'£~S <br />S l~~~ C c <br />/I <br />I~gtar} Pu lie ~+ <br />bh Commission expires: / .?' e?'Z'-dam <br />SIGNATURES hIUST BE IN BLUE INK <br />At:~MfMS}WRE\VSFOIL\fS~~B?ICOIO.APP 06~2:~99 <br />