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- 6 - <br />~erti5cation: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.5-1 10(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent roan-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-I I5(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit <br />boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-1 15(4xf), C.R.S.). <br />4. As the applicanUoperator, l do not have any mining/prospectingoperetions in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.RS.). <br />5. I understand that staternents in the application are being made under penalty of perjury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-5-503, C.R.S 1984. <br />Signed and dated this ~ ~ day of ~ ~ _, ( r ` <br />Lu r s I'Vl . UfN,~u2.Z- [f Corporation Attest (Seal) <br />ApplicanUOperator <br />Signed: ot-~t~ <br />Title: (1/.~AJo.o_~ Set- r EntPLo y e~ <br />State of ~ 10raC V ) <br />ss. <br />County of 0 k ~~~ r ) <br />~M. <br />The foregoing instrument was acknowledged before me this <br />•i / <br />N~T~ ~ B ``JP~ <br />O%- COLD <br />My Commission Expires 09/29/2002 <br />as <br />Siged: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />day of 'I t~'I / 199 . by <br />of_~>/o/1 jjjhA <br />~r <br /> <br />Notary PubliE <br />My Commission expires: '- Z 9-ZOdi` <br />SIGNATURES MUST BE IN BLUE INK <br />M:1MAllSHAItE\VSFORMSLR27COl0.APP 02/10/99 <br />