Laserfiche WebLink
-8- <br />Certifieatlon: <br />As an authorized representative of the applicant, I hereby certify rtrat the operation described has met the minimum requireroenis <br />of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent rr>an-made stn[chtre(s) in existence at the time <br />this 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.R.SJ. <br />2. No mining operation will 6e located on lands where such operations arc prohibited by law <br />(Section 34-32.5-115(4x, C.R.S.; <br />3. As the applicant/opcrcator, I do not have any extraction/exptoratian operations in the State of Colorado carrently in <br />violation of the provisions of the Colorado Land Reclamation Act for the 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 ~e being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misderneaztor pursuant to Section t 8-8-503, C.R.S. <br />17Wa jona hos born epprooed by tks AfGrd Load Rerlaaarrioa Booty parraaat ro scdioa 34-323-111,CRS, ojrbe ColorirJn Load <br />RtdaraadoaANjordeF.xtrwcrloaojCoashnetlonMaterL/s. AayoheroNoaoraadiJicaMoaojrblsjonasboAraalrGvolllagaay <br />poradr isswtd oa the okered er arodyied jona aad sorb}ed rAie openror b cease aad desLd orders aaJ doll peaolNes jor operating <br />wlrboar a penab panaaatW stctloa 31-325-113, GRS <br />signed and dated this ~ day of /VOl/~,mf L°j" , ~. <br />ApplicantlAperator or Compan Name <br />Si <br />Title: V, F ~ c^n `~si~,G C <br />State of D~ a~~ ) <br />County of R~ ~I I1'1~~ ) ) <br />If Corporation Attest (Sea!) <br />t!~/ <br />Signod: v <br />Corpora Se ary or Equivalent <br />Town/CitylCounty Clerk <br />The foregoing instrument was acknowledged before me this ~ day of l~ ~--~ <br />by 'Y~P~tD ~RlscilEQ- as J(P nF (ltxra-itaYi~ of V~'~~ <br />Stye, f-Pon1Cil~n. rarcrte~o ~ ~-trcGSw~i- ~~ <br />~~ ~n ~ ~ <br />~. <br />/= :~ <br />Notary Iblbiic <br />My Commission expires: ~ ~ ~ Z~~~Y <br />SIGNATURES MUST BE IN BLUE INK <br />O¢ <br />(Approve0OSl7!/iaDS) <br />~.. ~, MvT\r1~1. ny_ ~. <br />