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~ RECEIVED <br />" - JAN 2 9 2001 <br />Certification: <br />Division of Minerals and Geology <br />As an authorized representative of the applicant, l hereby certify that the operation described has met the minimum requvements <br />of the following terms and conditions: <br />1. To the best of my Imowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />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(4)(e), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section 3432.5-115(4)(1), <br />C.RS.; <br />3. As the applicant/operator, I do not have any extractionlexploration 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 <br />34-32.5-120, C.RS J as determuted through a Board finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor ptrrsuant to Section 18-8-Sb3, C.RS. <br />Signed and dated this ~~ ~ day of T <br /> <br />C G~7 IL ~l ^C -@ 'I '~ l p v~AC~C <br />Applicant/Operator or Company Name L / <br />Signed: - <br />Title: V~ r ~ A <, c r< c o f ~° ~ <br />7-TT <br />State of ~ ~ ~u r c_ c>r~ ) <br />ss <br />county of ~~ EG 1 ~ > <br />If Corporation Attest (Seal) <br />y V iCr P2E5,'ar.~T <br />Signed: ~1 'cL~' ~ CRST~~ C.•.V(.1FTL ~L%. <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this ~ ~ t{ day of J •, .. ~~-~~ a- ~ ~ i , <br />by GPr~ !c/ .7. /~e ~-...<-.., as J. ~'. ~</~~ of CF~i /~ ('~ _ _.~< <~..~<7 <br />~rrr,m°urrua„ <br />..~~` M , s r 'TTry ~ <br />~,,~~`~p7ARr~`rs'~~ otaryPublic <br />_~- <br />U'" pltE L tG ~'<~i s' My Commission e. fires: 01 ~ l) 3 <br />SIGNATURES`MUB'4"~~~IN BLUE INK <br />