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i <br />_~. <br /> <br /> <br />Certification: <br />i <br />As an authorized representative of the applicant, [hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />1. All necessary approvals tram local government have been applied For (Section 34-32S-1 10(1)(a)(viii). <br />2. To the best of my knowledge, al] significant, valuable and permanent man-made structure(s) in eeistence 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 34-32.E-1 l~(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 by law (Section 34-325-1 l~(4}(f), <br />C.R.S.). <br />4. As the applicandoperator, I do not have any tninine/prospecting 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.~-120, C.RS.). <br />~. 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 pursuant to Section 18-8-503, C.RS. 1984. <br />Signed and dated this 24th day of <br />United Companies of Mesa County, Inc. <br />Applican Operator <br />Signed: <br />Tide: Vice President <br />State of Colorado <br />County of Mesa <br />) SS. <br />The foregoing instrumrnt was acknowledged before me this 24th <br />Peter Siegmund ~ <br />2001 <br />, <br />~` /, <br />If Corporation Atte'sf (Seal) ° ~ ~ ' , ~' <br />' ~- <br />:~ :., <br />Sign 19i <br />Corporate S or Equivalent <br />Town/City/County Clerk <br />day of July 2001 , by <br />United Companies of <br />_ Of Mesa County, Inc. <br />=o PR Y PUe ~ Q~ / <br />~' !~ ~U~<l~vt ~ • ~r'1 a <br />~QENElAEV6 Notary Public Genevieve M. lilecha <br />• I M. BLECW- <br />s~'~ ,~O My Commission expires: April 4, 2003 <br />SIGNATURES MUST BE IN BLUE INK <br />Vice President <br />