Laserfiche WebLink
-g- <br />Certi6cstion: <br />As an authorized representative of the applicant, I hereby certify that the operation describedhas met themirmnrmr roquiremartsof <br />the following terms and ceditiars: <br />1. To the best of my knowledge, alt significmrt, valuable and permanent man-made stnrdure(s) in existence a[ the time tlris <br />application is filed, and locatod within 200 feet of the proposed affaxed area Gave been identified in this application <br />(Sectim 34-32.5-115(4xe), C.RS.). <br />2. No mining operation will 6e located on lands where such operations are prohibited by law <br />(Suction 34-32.5-115(4xt), C.RS.; <br />3. As the apphcant/aperator, I do not have arty extraction/exploratier operations in the State of Colorado currently in <br />violation of the provisions of the Cdorado Land lleclamation Act for the F.xtractier of Construction Materials <br />(Battier 34-32.5-120, C.RS.) as detennured though a Board finding. <br />4 [ understand that statements in the application are being made under penalty ad'perjury and that false sfatemdrts made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Thb john bas been approved by the Mined Load Reclamation Board pursamrt to section 3d-32.J-Il1,CRS, ojdre Cnfo>•ado Lmrd <br />Reran Aajor the F.xdattion ajConsnaAion MaWiola Any aAYr~ion or modyicatian ajdFir jorm rltaurGwb b .»iding arty <br />ptrnrQ tarred on acre aUoed err nrodifiedjarm and wb1aR Me opevalar ro eeme and desae orders and avi[pewabties jos aprro<ag ni/iaG <br />a permirpwsaanr ro redron 34 31.5-1I3, CRS <br />Signed and dated this ~ day of L ~0 ' <br />~- <br />__ __ ~~. <br />M.q. LoncrE~e Cons~rvafon Tre. <br />Applicant/Qperator or Company Name <br />Signed: / ~ - <br />Title: ~25idenT <br />State of Co%/oaio ) <br />ss. <br />Courrty of /t//BSG ) <br />If Corpeation Attest (Seal)- - % <br />- ~:. - <br />Signed: <br />Co to Secretary or 'v ent <br />Town/City/County Clerk <br />Tire foregoing i~tnmrart was aclnrowledged before me this ~~ C{ day of t{~l.L Gt,l ~ ~ ©`J <br />by /Ufa/~in f~2Ca//Gttra as ~.r5i//en f of M•A• ~nciefr C'on5~ruc~rppi r.~c. <br />t~ ~.P~/ <br />N public <br />My Commission expires: (9 -/~ -aU~S <br />SIGNATURES MUST BE IN BLUE INK <br />u.,ran,~c,v,w~mv ~ ~x.a~ tMProv+d os/r vmos> <br />DNS <br />