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RECEIVED <br />-$- <br />MAR 2.3 2007 <br />CerKdica iI_on: Division of Reclamation, <br />Mining and Safety <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terror and conditions: <br />i. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected azoa have been identified in this application <br />(Section 34-32.5-115(4xe), C.R.S.). <br />2. No mining operation witl be located on lands where such operations are prohibited by Iaw <br />(Section 3432.5-i ]S(4xf), C.R.S.; <br />3. As the applicanUoperator, I donor have any extraction/exptoration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for die Extraction of Construction Materials <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 are punishable as a Class I misdemeanor pursuant to Section 18-8-503, C.RS. <br />Thb fora bas been approved by the Mined Land Reclamation Board parsaant to section 34-37.3-II2,C.RS, of the Colorado Land <br />Reclamation Act for the Extracdoa ojConstrnetlon Materials Any aberodea w modifleatton ajthis john shall result in voiding any <br />permit issaed on the altered or modified farm and snb, jeer the operator to cease and deslsf orders and civil petralHes for opaaNng <br />whhaut a permit parsuent to section 34-325-173, GRS <br />Signal and dated this ZO ~ day of M A~ N Zo~'~- <br />I,..Aruea ~.oeaoot L, L, G. <br />ApplicanUOpetator or Company Name <br />Signe, <br />Title: <br />State of [ s:.oel~L~e9 ) <br />ss. <br />County of '~ ,.rr- ) <br />1'he foregoing <br />~• by -- <br />as <br />was acknowledged before me this _~~ day of <br />NpTARY; <br />,PUBLtGr~ <br />•. ~ <br />~.~'_ ... '~[Q. <br />If Corporation Attest (Seal) <br />Sign <br />Corporate Se~Yetary or Equivalent <br />Town/City/County Clerk <br />Notary <br />My Commission expires: ~t->'l.''G~ <br />TURFS MUST BE IN BLUF, INK <br />M.'u,e,iy6erewsfixnnY'mwl,nid~ I IZ.hc <br />