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-8- <br />Certit-eation: <br />As an authorized representative of the applicant, I hereby certify ttuu the operation described has met the minimum requirermtmis <br />of the following terms and conditions: <br />I. 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 area have been identified in this application <br />(Section 34-32.5-115(4xe), C.R.S.). <br />2. No mining operation wi11 be located on lands where such operations are prohibited by law <br />(Section 3432.5-115(4xf), C.R.S.; <br />3. As the applicanUoperator, I donot have any extraction/exploration operations in the State of Colorado curretttly in <br />violation of the provisions of the Colorado Land Reclamation Act far the Extraction of Construction Materials <br />(Section 34-32.5-120, C.R.S.) as determined through a Board finding. <br />4. 7 understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein ate punishable as a Class 1 nrisdemeanor pursuant to Section 1g$-503, C.R.S. <br />Thtr jarm has boa approved 6y the Mined Land tYeelaaudioa BoaN parsuanr to sedioa 3I-32.5-I J2,CRS, ojtlre Coloredo Land <br />ReelaaradonAdjorrbeExrrectloaojCoastmetioaMatmLis AayalferaNeaerarodfJ&aNoaojthfrjonashaRrewhlwwrfdlagaey <br />perarit Issued ou du altered ar med(lffed jorar aad subject Nte operator ro cease aad desht ardas aad clril pewahies jar operating <br />whbaal a pcradt ptrraueat M saBoa 34-32S-J2.t, GRS <br />Signed and dated this ~ day of N~!/P~~~Y , ~. <br />GoG~t° ~~7Cf~rG°, ~. <br />ApplicanUOpeaator or Compan Name <br />Sign <br />Title: V ~ ~,^~ ~i9-,Cf C <br />State of l~lD~-(~p~ ) <br />ss. <br />County of ~-:~ B-l lY1F.~~ 1 <br />If Coryoration Attest (Seal) <br />~~/ <br />Signed: t~ 2.c v <br />Corpo~ S~relary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before the this ~ day of <br />by 'BRAD FP-JCik~ as V ~ r,~ a of <br />Stems FPorttC14~. 5cknt-l ITreuStu~f-- ~ <br />c~t'~,~' HQ^y Notary blic r~ ~ / ,~ <br />,~~TR14~S'j~ My Commission expires: ~ ~ U ZDOW <br />SIGNATURES MUST BE IN BLUE INK <br />O¢ <br />cn~.o~ed eui inoas> <br /> <br />