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01!26!01 FRI 10:09 FAX i1947~ 26 TRANSIT MIX CONCREIT~y,CO. 13!002 <br />.~_ <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 />1. To the best Of my I.vowledge, all significant, valuable and permanentthan-made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-I 15(4)(e), C.R.S.). <br />2. No mining operation wall be located on lands where such operations are prohibited by law (Section 3432.5-115(4)0, <br />C.R.S.; <br />3. As the applicantloperator, I do not have any extractionlexploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Conswction Materials (Section <br />34-32.5-120, C.R.S.) as determined through a Board finding. <br />4. I understand that statemtnts in the application 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. <br />Signed and dated this ~~ ~ day of 1 ~ .. ,- ti~ ., a-cc I <br />o^ <br />Applicant/Operator or Company Name <br />Signed: /~ ,,' <br />Title: L1 ,! ~~~ ~ e% " ~ ' <br />state or C ~ ~~ ~ ` ~ <br />) SS <br />County of ~ r f',.~ ~ ) <br />Town/City/Counn• Clerl: <br />The~foregoing instrument was aclmowledged before me this ao "~ day of •1 ~. ~ K.~ ~ ~ ... ~• r <br />bylUC ~-~ [c/ ~ Nr-r.~,-t as U f ~4 5: a „'f<• of CAS! ~ C~..~ ter` C„+wtn~.~y <br />luau... <br />`c~c\0-(ARY'sy,'~ lei]/< u'N e 1- <br />~d.G+- <br />~~~ •: \~' <br />r ` tr ,~o a"~ 7 Public <br />F'i t, ,vim <br />~: <br />.` My Commission expires: ~ - l o : L3 <br />,,. ~ n W n •`~o•~• <br />[t Cotporatioa Attest (Seal) <br />Signed: rti -:•r~l(/-!t `tli'C~~!/ c^nsr~tCrti•~~zanz <br />Corporate Secretary or Equivalent <br />SIGNATURES MUST BE iN BLUE iNK <br />