PERMFILE119467

• Permit No: M1995008
• IBM Index Class Name: Permit File
• Doc Date: 2/3/1995
• Doc Name: APPLICATION FORM
• Media Type: D
• Archive: No

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Certification:
As an authorized representative of the applicant, I hereby certify that the operation
described hoe met the minimum requirements of the following terms and conditions:
1. This mining operation will not adversely affect the stability of any
significant, valuable and permanent man-made structure(s) located within two hundred
(200) feet of the affected lands. (However, where there is an agreement between the
applicant/operator and the persona having an interest in the structure that damage
to the structure is to be compensated for by the applicant/operator (Section
834-32-115(4)(d), C.R.S. 1984, ae amended), then mining may occur within 200 feet.
Proof of an agreement must be submitted to the Office prior to the decision date.)
2. No mining operation will be located on lands where ouch operations are
prohibited by law (Section 34-32-115(4)(f), C.R.S. 1984, as amended);
3. As the applicant/operator, ,I do not have any mining/prospecting operations in
this state of Colorado currently in violation of the provisions of the Mined Land
Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through
a Board finding.
4. I understand that etatemente in the application are being made under penalty
of perjury and that false etatemente made herein are punishable as a Claee 1
misdemeanor pursuant to Section 18-8-503, C.R.S 1984, as amended.
Signed and dated this ~O"~'/ day of
Fremont Paving & Redi-Mix, Inc.
By:
Title:
State of `'e+-Y .9~-e--e'--O )
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County of ~/21LrYt~- )
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If Corporation Attest (Sea3)~.._._--= ~~ :''
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Corporate Secretary or Equivalent
Town/City/County Clerk.
The fore/g~oing instrument was acknowledged before me this o~~)day of ~ ,~~,
by ~ as ~~1 of
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My Commission expizes:
2823E
(IO/I4/94)