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-~- <br />~grtification: <br />As 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 ofmy knowledge, all significant, valuable and permanent man-made stmcture(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.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by law <br />(Section 34-32.5-115(4)(f), C.R.S.; <br />3. As the applicant/operator, I donothaveany extraction/exploration operations in the State of Colorado curremly in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials <br />(Section 34-32.5-120, C.R.S.) as determined through a Board Ending. <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, C.RS. <br />This jorm has been approved by the Mined Land Reclamation Board pursuant to section 3•h32.5-11$C.RS, ojthe Colorado Land <br />Reclamation AMjor the Exbaction ojConstruction Materials. Any alteration or modification ojthis form shall result in voiding any <br />permit issued on the altered or modified jorm and subject the operator m cease and desist orders and civil penalties jar aperathrg <br />without a permit pursuant to secdon 34-32-123, C.RS <br />Signed and dated this ~ day of ~/ u ~ t. r7"' . a o0 ~ <br />Linke Construction ~. /~lC. <br />Applicant/Operator or Company Name <br />Signed: ~~ ~_____~~ /~_..sfo <br />Title: President <br />State of ~,2 CO 4L .o ~O 1 <br />~ ) ss. <br />County of C 2 A ./~ ) <br />Tf Corporation Attest (Seal) <br />%-~'' 'rC <br />Signed: ' ~` ~~' .~1~~- <br />J /+. <br />Corporate Se~jetary oralent <br />Town/Cit~/4•gea° ~,Clefk= <br />:?~ t;4. <br />`qe1 <br />`~.! ., ~ r <br />The foregoing instnunent was acknowledged before me this ~~ ~ day of ~ i.e ri tt . t 1F" <br />by Richard i.inke as President of T.inke Construction t~ /NGo <br />~~~ ~~-~ <br />Notary Public <br />My Commission expires: ~-d to - <br />SIGNATURES MUST BE IN BLUE INK <br />w~•••sota~.aoa <br />