PERMFILE120949

• Permit No: M2007013
• IBM Index Class Name: Permit File
• Doc Date: 2/16/2007
• Doc Name: New 112c Appl
• From: McAtee Construction Co.
• To: DRMS
• Media Type: D
• Archive: No

-8-
Certification:
As an authorized representative of the applicant, I hereby certify that the operation described has met the mutimum requirements of
the following teens and conditions:
1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) th existence at the time this
application is filed, and located within 200 feet of the proposed affected area have been identified in this application
(Section 34-32.5-115(4)(e), C.R.SJ.
2. No mining operation will be located on lands where such operations are prohibited by law
(Section 34-32.5-115(4)(!), C.R.S.;
3. As the applicanUoperator, I do not have any extraction/exploration operations in the State of Colorado currently in
violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials
(Section 34-32.5-120, C.R.S.) as determined through a Boazd finding.
4. I understand that statements in the application aze being made under penalty of perjury and that false statements made
herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S.
This form has been approved by the Mined Land Reclamation Board pursuant to section 34-31.3-712,C.RS., ojthe Colorado Land
Reclamation Act for the lixbadion ojConstrudian Materials. Any alteration or modification ojthts form shall result in voiding any
permitissued on the altered or modifiedjorm andsubjec4lhe operator to cease and desist orders and civilpena/lies jorpp~eting x>about
a permit pursuant to section 34-32.5-I23, C.RS. ~"'`~ ~ = - ,`~,
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Signed and dated this a day of I `I O vP th ~ , C~t3 to ~ ;~ ,.1 ~
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McAtee Construction CO.
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If Corporation Attest (SealY'.i`Y ° ` Q' -
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Signed: / ~-- ~~. ~~ Signed: `f ~Cllt ~ G ~U~l~tt~
~f Corporate Secretary or Equivalent
Title: Vice President
State of Colorado 0 ~
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County of Logan ~ ~
Town/Ciry/County Clerk
The foregoing instrument was acknowledged before me this _~ day of ~V ~UQYYI HOC {~ _ ~,~7 ,
by William G. Lauer ~ as Vice President ~ of McAtee Construction CO. p
PIOTAr~Y I'JBLIC
STATE Ct= COLORADO ~)
MyCtxrlmtsslon Er•,:tnsJ;muaty23,2D08
NMa Public
My Commission expires: ~ °~3 ©~
SIGNATURES MUST BE IN BLUE [NK
M:MinWm\vil'om~e~Coawuction 112.dac (Approved 05/11!2005)