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G- <br />Certificafion: <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. All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected azea have been identified in this application <br />(Section 34-32.5-1 IS(4)(e), C.RS.). (NOTE: For 110 operations, the affected area includes all lands delineated by the <br />permit boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.RSJ. <br />4. As the applicantlaperator, I do not have any mininglprospecting 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 34- <br />32.5-120, C.RS.). <br />5. I understand that statements in the application aze 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. 1984. <br />r <br />Signed and dated this ~_ day of ~ ~ ~r i yl~h- ~C~'~l <br />Stone Cliff Investments, LLC If Corporation Attest (Seal) <br />Apphcant/Ctpetator <br />Signed: Signed: <br />e vic c <br />Corporate Secretary or Equivalent <br />Title: Owner Town/City/County Clerk <br />State of Colorado 1 <br />ss. <br />County of Huerfano ~ <br />k-~ LL ,, <br />The fo,~1oing instrument was acknowledged before me this ~~ ~ day of '~C~-~lu~ :~fb~, , by <br />~G~~ u~~~~ ~~,,~~ ~ ~v7af ~o <br />~ ~~sPdE~ , of dhr~ C~c., <br />~, c <br />:~ ~O'CARY~.'f'~': <br />• ~ - ' pf~ltilCli.~ <br />PUBS-~G `Q~~etary 'tic <br />sTgTE 0 F CO~~Q''My Commission expires: a J' rd~J~ <br />GC.CI <br />SIGNATURES MUST BE IN BLUE INK <br />