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<br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected azea have been identified in this application <br />(Section 34-32.5-115(4)(e), C.R.S.). <br />2. 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 />3. As the applicantloperator, I do not have any 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.R.S.) as determined through a Boazd Ending. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor ptusuant to Section 18-8-503, C.RS. <br />Signed and dated this 1. f ~~ day of ~,~~/.P~c ?Do / <br />~t~CC~la ~~j ~LQJ/~7~sa~/ <br />~ ,iY ~%~~ If Corporation Attest (Seal) <br />ApplicandOperator or Company Name <br />Signed:6ts/./~/~t J1' ~~~~.~s~ Signed: <br />Title: ~.~z!/~LCi'Ar~ <br />State Of Colorado ) <br />) SS <br />County of Rio Blanco ) <br />Corporate Secretary or Equivalent <br />TovvnlCirylCounty Clerk <br />T7re foregoing instrument was acknowledged before me this 25th day of October 2001 <br />by Diana K. Watson as Applicant of Stout-Amick Pit <br />,~ <br />1 1~.--~ <br />Notary Publi = -_- ,V ,., ;~ - <br />My Commission esprrs=".=8_= 6`D4'~ <br />,_rr ..... .. iro <br />SIGNATURES MUST BE IN BLUE INK <br />