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<br />-6- <br />Certification• <br /> <br />Ae an authorized representative of the applicant, i hereby certify that the operation described <br />has met the minimum requirements of the following terms and conditions: <br />1. AL1 necessary approvals from local government have been applied for <br />(Section 34-32.5-11O(1)(a)(viii). <br />2. To the beet of my knowledge, all significant, valuable and permanent man-made structure(s) <br />in existence at the time this application is filed, and located within 200 feet of the <br />proposed affected area have been identified in this application (Section 34-32.5-115(4)(e), <br />C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the <br />permit boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law <br />(Section 34-32.5-115(4)(f ), C.R.S.). <br />4. Ae the applicant/operator, I do not have any mining/prospecting operations in the state <br />of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for <br />the Hxtraction of Construction Hateriale (Section 34-32.5-120, C. R.S.). <br />5. I understand that statements in the application are being made under penalty of perjury <br />and that false statements made herein are punishable ae a Class 1 misdemeanor pursuant to <br />Section 18-8-503, C.R.S 1984. <br />Signed and dated this ~~n day of /'/ / 9 9 7 . <br />Applican r //for pp <br />Signed: ~J_~(Y ~n.-Q~ <br />Title: ~~~~5~~ , <br />1 <br />If Corporation Attest (Seal) <br />Signed: Y~i+-Q~(~eAia ( 1~" QG~----- <br />Corporate Secrets y or Equivalent <br />Town/City/County Clerk <br />State of l~si~r- ) <br />n~ ) 89 <br />County of (/~}/ ) <br />The fo <br />e <br />going in~trum <br />en <br />t was acknowle <br />d <br />ged befo <br />re me this ~~ day of <br />~ , ~, <br />r <br />// <br />QQ <br />~ <br />7 <br />/~~ <br />by ~7lYUlcrd) ~ l.~L $~. as ~l ~ ,Q <br />F 1~2ccQ ~{ <br />of ~tLli~ <br /> <br /> ~ c~ <br /> <br />Hy ~~nn~~1-4 ~' t ~ <br />Comm eion expif~s: /nd <br />c~n;~C <br />01/02/96 ?H21 FCO.130 <br />