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~~. <br />~~ <br />y- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />t. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />application is fled, and located within 200 fat of the proposed affected area have ban identified in this application <br />(Section 34-32.5-1 i5(4)(e), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-1 IS(4)(f), <br />C.RS.; <br />3. As the applicantloperator, I do not have any exiraction/exploration 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.) as determined through a F,oazd finding. <br />4. I understand that statancats in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Sigoed and dated this ~ ~ ~ day of V ~ .. ~,. ~ ~ ti ~ ° ~ ~ `• ~ ° r <br />_~ `: ',„; <br />~ _, <br />'' r.ii- <br />~~~" (~ C uY+c ~i. >~ C a .---s~~-.-J If Corporation Attest (Seal) <br />Applicant/Opcrator or Company Name <br />Signed: ~l~Q.-. ~~ <br />Title: U ~ its ~ . eo ~ ~ . <br />-~- <br />State of ('~l~Q~ ) <br />ss <br />County of ~ ~ CAS <br />Town/Ciry/County Clerk <br />The fo/r~egoing instrument waz aclmowledged before me thins ~ day of S ~ ,~ a(X~ ~ , <br />by li.~-~ of c~ ~ . '~,Lt rx~: ws as ~i P q I' Ar S l~(~~ of ~ ~/7.~wG ~ 171,1, 4 (~a~u n~ ~r <br />,~ `apTARy•'• ''~l•': otaryPublic <br />~~- <br />gn ~~G~ ~ - V~c~~jlES.df~/~ <br />Si ed: ~t~ </ ~.4s~ C'~2~c2f <br />Corporate Secretary or Equivalent <br />pUE"_ fir' ~ ? My Commission expires: ~ ~ - O ti <br />C w^ <br />...... ~. <br />SIGNATURES 1VP13&'l;~~B~`!N BLUE INK <br />