Laserfiche WebLink
7- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />L All necessary approvals from local government have been applied for (Section 34-32.5-110(I)(a)(VIII) <br />2. To the best of my knowledge, all significant, valuable end permanent man-made structure{s) in existence at the time this <br />application is filed, and located within 200 fcel of the proposed affected area have been identified inthis application (Section 34-32.5- <br />115(4xe), C.R.S J. (NOTE: For 1 10 operations, the affected area includes all lands delineated by the permit boundary. ) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4xt), C.R.SJ. <br />4. As the applicant/operator, I do not have any mvting/explorationoparations in the State of Colorado curtenlly in violationofthe <br />provisions of the Colorado Lend Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements m the application are being made under penalty of perjury and that false statements made herein ere <br />punishable as a Class 1 misdemeanor pursuant to Section i8.8-503, C.R.S. 19g4. <br />This jorm bas been approved by the Mined Land Reclamation Boardpursuant to section 30-31-5-lIO,C RS., ojthe Colorado Land <br />ReclamanonActJorthe Ea>roction oJConstruction Materials. A»y alteration or modification ojdtisjorm shall resah in sntdurg any <br />permit issued on the altered or modifiedjorm and subject the operator to cease and desist orders and civil penabfes jot ope~atmg <br />wibFoat a permitparsaaNto secton 34-32.5-113, CR.A - .. ' ~, <br />Z`Y7~ da of Vurv€' 2005 ' ;,:• . ~ ', <br />Signed and dated this y ~ ~-'%- „ _ <br />~CEF 1'Ro4ucrs 1 /roc <br />Applicant/Operator <br />Signed: ~ <br />'Title: 1'~ t~- <br />Sate of ~(.7C p,e~Jf7 ) <br />/y _ ) ss. <br />County of l ,7`~~ ~t<~ 1 <br />- _ ~ ~'' <br />O <br />If Corporation Attest (Seal) 3 v ~ E <br />~M ri <br />Signed: J L.U/rii ~`-"' <br />Co rate Secretary ox Equivalent Y <br />Town/City/County Clerk <br />T.~4 ~/uNE 1065 <br />The foregoing instrument was acknowledged before mer~this 2>3 day of , <br />by S^''(~-4D In-ie'^t OrezK as IF~cSt4~.f'T- ~'~y" of ~CA {~OOUCr~/~NC- <br />~/7~ ti,n,-n1~ ~~h/1 J <br />Notary Public /- <br />My Commission expires: ~.r <br />SIGNATURES MUST BE IN BLUE INK ,w4-wo~~,_e.~~.~ <br />Mivninkharehsfomu\Comuudiont lD (Appro~~a os;tuzoos> SHARON K. CARR <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />My Commission Expires 6/16/2007 <br />