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<br />certification: <br />All necessary approvals from bcal government have been applied for (Section 34-32.5-t 10(I xaxV III). <br />-. <br />2. 'fo the best of my lmowledge, all significant, valuable and permanent man-made s[mctute(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 34-32.5-115(4~e), C.R.S.). (NOTE: For 1 t0 opettions, the affected area includes all lauds delineated by the permit <br />boundary,) <br />As an authorized representative of [he applicant, l hereby certify that the operation described has met the ntinimivn requiretttenis ofthe <br />following terms and conditions: <br />3. No mining operation wilt be located on lands where such operations are prohibited bylaw (Section 34-32.5-t t 5(4xf), <br />C.R.S.). <br />4. As the app(icanUoperator, I donut have any mininglexpbtation opemdons in the State of Colotado cnrtemly in violation of <br />Ole provisions of the Colorado Land Reclamation Act for the Extraction ofConstniction Materials (Sectiam 34-32.5-120, C.RS.). <br />5. I understand timt statement in the application are being made underpenaity ofpesjury and dot false statemems made herein <br />are punishable as a Class 1 nrisdetucanor ptasuant to Section t 8-8-503, C.R.S. 1984. <br />-7- <br />Tkts jorta has been approved bl'tbeMinedLaud Redamatioa Board pursuant to secHaa 34-31.S-ll D,C.R.S, ofHte Colorado Land <br />Redamatioa Act for the Ertradfon ojConstrucBan Marertds. Any alteration or modij7cation ojthts jorm shall,rsalt in iroiding <br />aay permit iasaed on tFe ahered or atodjJkd jorat aad subjec! tke operator to cease and desist orders and dull penalties for <br />operating without a peratit pursuant to section 34-32.5-113, CRS <br />Signed and dated this 21 day of July , 2 0 0 7 <br />Afonty Yocum <br />ApplicanUOperator <br />Signed: _ /~ <br />Tide: member/manager <br />State of (,olorado <br />County of Las Animas <br />The fo <br />_, by <br />,~ <br /> <br />ss. <br />uP <br />~~ ~~~ <br />Notary Public <br />My Commission expires: .3' ~ 7 ~~ <br />SIGNATURES MUST BE IN BLUE INK <br />i 10 (Approved OS/1 I1200~ <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secmtary or Equivalent <br />Towrr/City/Covnry Clerk <br />before me this d~ ~,(~~ day of , <br />as 1`Nx[1LiQ me.mbe,- of <br />