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- 7 - <br />Certification: <br />~s an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this applicarion is filed, and located within 200 feet of the proposed affected azea have been identified in Uus application <br />(Section 34-32.5-1 IS(4)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section <br />34-32.5-I 15(4)(t), C.R.S.; <br />3. As the applicanUoperator, I do not have any extraction exploration operations in the State of Colorado cturently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.5-I2Q C.R.S.) as determined through a Boazd fmding. <br />4. I tmderstand that statements in the application are being made under penalty of perjury and that false statements <br />made herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this e~ ~ S~' day of <br />p'~Jo~ <br />Fi91e~,etJ/1')cJy~,~irv L~ C~' <br />•ApplicanUOperator or Company Name <br />Signed: <br />Title; ~1~-.~c..~ i.v~i ~4 rT,v e/ <br />Slate of CG ~ 2Prt~d ) <br />ss <br />County of ~~CI t Et_ 1 <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acktrowledged before me this a ~ Si day of ~ ~1 ,0100 `} , <br />by -Ieh19-t1~t1 I~ • f 1LE as Mt9YtKlGinG (~9Rt111L`4 of 1=i1Rfi>zurn wut?r/n L~~~ <br />A,S;~ <br />Notary Public Nom:-.p G :O <br />9~'•. ~t7 L...•'QO <br />My Commission expues: ~ Op COOP <br />. IlyWmt~t Et~itot8~2006 <br />SIGNATURES MIDST BE IN BLUE INK <br />MdhiL'S~BD(.U1INFORMSIZB23C012.APP 10/1]/01 <br />