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<br />• .6- <br /> <br />Certification: <br />As an authorized representative of the applicant, i hereby certify that the operation described <br />has met the minimum requirements of the following terms sad conditions: <br />1. All necessary approvals from local government have been applied for <br />(Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made structure (s) <br />in existence at .the time this application is filed, and located within 200 feet of the <br />proposed affected area have been identified in this application (Section 3a-32.5-115(4)(e), <br />C.R.S.). (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 <br />(Section 34-32.5-115(4)(f), C.R.S.). <br />4. As the applicant/operator, I do not have any mining/prospecting operations in the State <br />of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for <br />the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements in the application are being made under penalty of perjury <br />and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to <br />Section 18-8-503, C.R.S 1984. <br />Signed and dated this ,~_ day of ~ft A.1 F- ~'Z <br />LC~ESTE2 .y ~ ~-~_ ~ Etirs <br />Applicant/Operator // <br />Signed: ~.:L~~~.~/JifJ ~~~ <br />Title: ~ CF~.V.~2 <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of Cr[~LU/2[~~d ) <br />ss <br />County of F/CG /7AL~ KtT ) <br />The foregoing instrument was acknowledged before me this ~ day of V(~Y1~ ~ ~ , <br />by ~`i41~(IYYI Q_. I/f_s+n l_ as ~1711Q.~' of ~A`Q,S~ffh lfu1T`lPv~~S <br />DOMONI A. TOLtt~ ~rn~.a_~ Q.. ~~ <br />NOTARY PUBLIC Notary public <br />STATEOFCOLORA00 MY commission expires: ~-O(1-~1rb <br />~,.zarx~z~ax-.. <br />SIGNATORBS YQST 88 IN SLIIS INR <br />OS /27/97 2821FC0.110 <br />