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7 - <br /> certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> described has met the minimum requirements of the following terms and conditions: <br /> 1. To the best of my knowledge, all significant, valuable and permanent man-made <br /> structure(s) in existence at the time this application is filed, and located within 200 <br /> feet of the proposed affected area have been identified in this application (Section 34- <br /> 32 .5-115 (4) (e) , C.R.S. ) . <br /> 2. No mining operation will be located on lands where such operations are prohibited by <br /> law (Section 34-32.5-115(4) (f) , C.R.S. ; <br /> 3 . As the applicant/operator, I do not have any extraction/exploration operations in the <br /> State of Colorado currently in violation of the provisions of the Colorado Land <br /> Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S. ) <br /> as determined through a Board finding. <br /> 4. I understand that statements in the application are being made under penalty of <br /> perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br /> pursuant to Section 18-8-503, C.R.S. <br /> Signed and dated this day of <br /> tic r^� 1�.� If Corporation Attest (Seal) <br /> Applicant//Opepra�Itornor /C/ompany Name <br /> Signed: ./��v / // ...e Signed: tX '-/ //C�-^-✓-..> <br /> i <br /> � A � Corporate Se retary or Equivalent <br /> Title: �)�o•`r-�r� � • ac- 7� Town/City/County Clerk <br /> State of cl� ) <br /> //^y�_-�� ) s s <br /> County of C rr 6 PAS6 ) f '/ mn <br /> The foregoing instrument was acknowledged %�b�efore m' 1e this �� day ofVAJ//u��ARV 1999 , <br /> by VUC 1 1k;&AAJ J^ as V f LE r/C6S/QEN7 of L �� L d4JCKE7E (� <br /> •^ - � '^ Notar Publi <br /> - --� My Commission expires: <br /> �I00 <br /> +•-` �� SIGNATURES MUST BE IN BLUE INK <br /> 06/26/97 2823FCo.112 <br />