Laserfiche WebLink
-~- <br />Certification: <br />As an authorized representaflve of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and wnditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structures} in existence at the time <br />this application is 61ed, 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 aze prohibited bylaw (Section <br />34-32.5-115(4)(f), C.R.S.; <br />3. As the applicandoperator, I do not have any extraction/explorafion 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 fmding. <br />4. I understand that statements in the application aze being made under penalty of perjury and that false statements <br />made herein aze punishable as a Class 1m,~is1demeanor pursuant to Section 28-8-503, C.R.S. <br />Signed and dated this Z~~ day of Y V ov e._ ~r zCOZ. `, y "/'' /''•, <br />_ ~-,- <br />Scc„i ,-cst <br />YV l~M~~~ <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged be~fo"re me this ~1 '-- day of N1j11'P.,Wl ~}'U _, `~' nz , <br />by ~~~_ as NA,1fPGG1~~ {~ Q(ViSfhYl ~dUYCQ of L~- ~t'UILi1, ~t9h.0~IhCt~1l1?1 <br />YtRI', <br />0 ~~TA,QF <br />• Notary Public <br />N~ :•q G : •~ My Commission expires: Q <br />rFOF cot-°~ <br />.N SiT $E IN BLUE INK <br />~'~ .\": <br />If Corporaflon Attest (Seat) ' <br />Signed: <br />Corporate Secretary or Equivalent <br />N:WfW~BDCIMWFOR4LS~2823C012APP 10/17/07 ~y ~~~Ofi ~l(8S <br />State of I.CJI CTT~lI~U ) <br />ff'' )ss <br />County of W~~ ~ ) <br />