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Certification: <br />-~- <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. To the best of ary lmowledge, all significant, valuable and permanent man-made structure(s) inexistence 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(4xe), C.RSJ. <br />2. No mining operation will be located on lands where such operations are prohibited bylaw (Section <br />34-32.5-115(4)(f), C.RS.; <br />3. As the applicandoperator, I do not have arty extraction/exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.5-120, C.RS J as determined through a Boazd finding. <br />4. I understand that statements in the application are being made corder penalty of perjury and that false statements <br />made hericln are punisltabte as a Class 1 mildemeanorr pursdant to Section I8=8=503, C.RS. <br />Signed and dated this 5th ~y op APRIL <br />OTERO COUNTY <br />Applicam/Aperator ceCompany Name t <br />signed: ~:Q_M~ns~`h S. \"n7~IQsh <br />Title: PUBLIC WORKS SUPERVISOR <br />State of 1 <br />ss. <br />County of 1 <br />2004 <br />O~¢O COG2 ffCorporationAttest(Seal) <br />®T •'•. ~ <br />i. Sti`;L r8n~~ <br />~'•.,• L ; ~ Corporate Secretary or Equivalen <br />OR A00 Town/City/County C1er1: <br />The foregoing instnunent was aclmowledged before me this <br />as <br />day of <br />of <br />Notary Public <br />My Commission expires: <br />SIGNATURES MUST BE IN BLUE INK <br />by <br />M:~~~~~~ l~z.mc oaunom> <br />