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~~>~: <br />_g_ 6~,L ~G,~R\1~~~ <br />As an authorized represeruative ofthe applica<tt, I hueby certify that the operation desaibedhas met thgmuu~~t ~l m of <br />the folknving terms and cartditions: <br />1. Ta the best of my knowledge, all signific®t, valuabh:and pertneoartman-made strutxrne(s) in existeatct at the tip this <br />application is filed, acrd k~ed within 200 feet of the proposed affected area have been idemified m this application <br />(Section 34-32.5-I IS(4xe), C.RSJ. <br />2. No mining operation will be fixated on lands where such operations errs prohibited by law <br />(Sextioa 34-32.5-115(4xf), C.RS.; <br />3. As the applicanUoperator, l do nd have arty extratrwolexpkuation operatia~s in the State of Colorado taurently io <br />violation of the provisions of the Colorado Land Reclamation Aa far tlw Extraction of Corestnection Mateaials <br />(Section 34-32.5-120, C.RS.) ss determined through a Botvd finding. <br />4. l understand that statunents in the application are being made under pexlalty of perjury and that false statemems made <br />he+cin ere punishable as a Class 1 misdememtor putsuam td Stxxion 1 B-&503, C.R.S. <br />IA8 jwas Mo, bear approved 6y de Allred Lead RedaaaNae Boer) pwarad m settioe 3J-3S.S-I12,CRS, 9flke Colwode Laed <br />Raalaaro4ion Adjw 8ie Ex4ecrtaur oJCansowaiax Moferiefx My sAxnariaw w,sadyn:ame ajabirjwrn sAaII reaek in .ei~mg asy <br />pdeririusedwr aweaCnedw rwodfJledjorer and.seb, jerrtlie apador memreaaddesal wdua awddviLpenaE6trfwgpsae'rig»rkart <br />e pemdt preawarm sraffoe 3/-3I.i123, CRS <br />Sigttod and dated this, day of ~/~~~ ~~oir .~D(7 <br />ApplicamlOperator or <br />If Corporation Attest (Seal) <br />Signed: ~ - . <br />COtpOta[e $ecretmy or Egeuvalatt <br />Town/CitylCounty Clerk <br />The foregoing instrument was aclmowledged before me this ~ day of ~~i~ ~AD~v <br />by ~ ~ as ~-P • ~/ r a(' of ~,f - N- .[.~ k~ ~ set, <br />NWarv Public <br />MY Coromissian expires1c21.4 ~7`, 0201 ~ <br />SIGNATURES MUST BE IN BLUE INK <br />tit:tmwvc~wrmm~Caewefm i ixaz (Approvadovt inoas> <br />State of / D/D 1~i~7 1 <br />~' ) ss. <br />