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-6- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the min¢nunrrequilemwts of <br />the following terms and conditions: <br />1. All necessary approvals from local government have been applied for (Section 3432.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanentman-made structlne(s) in existance 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 34-32.5-115(4)(e), C.RS J. (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 (Section 34-32.5-115(4xf), <br />C.RS.). <br />4. As the applicant/operator, I do not have lily mining/prospeciing 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 <br />(Section 34-32.5-120, C.RS.). <br />5. I understand that statements in the application are being made under penalty of perjury and that false a+A+P*~+ens made <br />herein are punishable as a Class 1 mic~emrsnor ptnsuant t0 Section 18-8-503, C.RS. 1984. <br />Signed and dated this ~ S~ day of ~~/~r - ~ c~C"~ <br />AZCO Construction. Inc. <br />Applicant/Operator ~~ <br />Sign"~~//l~~-~-~~" <br />Ronald E. Walker <br />Title: ~2QS. ~~i~' <br />State of ~ Gt-~-~ <br />ss. <br />County <br />foregoing instrument was acknowledged before me <br />If Corporation Attest (Seat) <br />Pr.- , <br />~: ~~ PY'. <br />r; ~ P ~' <br />?O~~~G <br />PU9 < <br />.GOB, <br />".STATE OF...~~~, <br />r` _'_, <br />day of ~ by <br />of <br />My c V scion e,{p;,~: MY COMMISSION EXPIRES 5~12~2005 <br />SIGNATURES MUST BE IN BLUE INK <br />M:~minlsiwe\vsfams\Co~LUCtion110 (05/062003) <br />