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-6- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation descnbed has met the minimum requirements <br />of the following terms and conditia~ns: <br />1. All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence 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 3432.5-115(4)(e), C.RS.). (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 bylaw (Section 34-32.5-115(4)(f), <br />C.RS.). <br />4. As the appficantloperator, I do not have a~ mininglprospecting 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 34- <br />32.5-120, C.RS.). <br />5. I understand that statements ul the application are being made under penahy of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. <br />Signed and datedthis /G day of r~'u,q~~ _Q C~_. <br />Applicant/Op ator <br />~'~~2 <br />Signed: n~1f'//~r~ Lr~~ <br />Title: ~~'~,2~~,0!' <br />If Corporation Attest (Seal). <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State ofC.Or/OB+tQd } <br />ss. <br />County of M ~ Ci ) <br />The foregoing instrument was acknowledged before me this ~ ~ day of ~ tti„ ~+ , ZOD ~ , by <br />~iobu'~' 41~ aauAhex as C~W/1Q C of V E.A/2Cf 5'}-an~2 ,~fOCluc`~-5, <br /> <br />SPRY ~ue4 ~ I h.~G ~-eM.a.Q.~~J <br />2~'~ ' :~' Notaly Public <br />~~ CYNTFIIA ~' <br />FERRATES '~ My Commission e7cpires:D7'8tO'~'I <br />SAT T BE IN BLUE INK <br />M:~mi¢\Share\vsfocma\Cp~shvaiq~130 (10/15/2001) c nG'~: (~~. <br />