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-g- <br />Certification' <br />As an authonzed representative of the applicant, I hereby certify that the operation described has met the mtttimum requirements <br />of the following terms and eondittasts: <br />1. To the best of my knowledge, all significant, valuab]e and permanent man-made structure(s) in existence a[ the ome <br />this application is filed, and located within 200 feet of the proposed affected area have been identified m thts application <br />(Sectron 34-32.5-115(4)(e), C.R.SJ. <br />2. No mining operation wtll 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 applicanUoperator, I do not have any extraction/exploration operations in the Stare of Colorado currently in <br />violation of the provisions of the Colorado Lmtd Reclamation Act for the Extraction of Cansnvction Matenals <br />(Section 34-32.5-120, C.R.S.) as determined through a Board finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein arc punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />This jorm bas bern approved by the Mbeed Land ReMamafion Board pursaaat to section 3I-31,5-111,C.RS, ojrhe Colorado Land <br />Reclamation Act jot the F.ziractlon ojConatruMion Makrials Arty afteraUon or modiJicaUon ojthis jorm shalt result in voiding any <br />permb issued on the altered or modljied jorm and sabJeM the operator to cease and desist orders and civU penalties jot opergtlng <br />without a permit pursuant fo section 3J-31.5-723, C RS. <br />Signed and dated this ~~ day of S ~ P7rJrC3eYz- 2006 <br />~~~i~~ <br />Granby Realty Holdings LLC IfCorpotationAttest(Seal) <br />ApplicanUOperator or Compan ome <br />Signed: Signed: <br />C rate Se or Equ valent <br />Title: V <br />orpo cr r <br />TownlCity/County Clerk <br />State of 1. ol.ol~p ) <br />ss. <br />County of ~/~at~(/~ ) <br />'Ihe foregoing instrument was acknowledged before me this <br />2006, by __i.,~l~(c 3~-r~},~rz, _ as <br />gJpTAR t/ <br />-.,. <br />~'U6LIG <br />day of __ ~ LY7~wI N ir~_, <br />of_nCZ~NdTEMt ~ }~UV1~r3G5 t~-C <br />V-/~v-1L~w~N ~-- <br />Notary pubh <br />My Cotnmission expires: ~~,Q~Z._,__ <br />N ~mn tlrK,~fenm rbmmr~wn I t] a,x (Appra~ed US/I 12VU5) <br />[N BLUE INK <br />