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'. 'Cert~cation: -6- RECEIVED NOV ? ~ 7006 Division of rtaclamatlon, Mining and Safety As an authorised representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the following terms and conditions: All necessary approvals from local government have been applied for (Section 34-32.5-111(1)(a)(13Q); 2. This entire mining operation will not affect more than 30 acres; 3. This mining operation wilt not adverselyaffect the stability of any significant, valuable and permanent man-made structure(s) located within two hundred (200) feet oFthe affected lands. (However, where there is an agreement between the applicant/operaiornnd the persons having an interest in the stmcture that damage to the structure is to be compensated for by the applicanUoperator (Section 34-32.5-t 15(4)(e), C.R.S. 1984, as amended), then mining may occur within 200 feet. Proof of an agreement must be submitted to the Office prior to the decision date.) 4. No mining operation will be located on lands where such operations aze prohibited by law (Section 34-32.5-1(5(4)(f), C.R.S. 1984, as amended); 5. As the applicanUopemtor, I do not have any mining~explorntion operations in this state of Colorado currently in violation of the provisions of fhe Colorado Iand Reclamation Act for the Extraction of Constmcrion Materials (Section 34-32.5-120, C.R.S. ] 984, as amended) as determined through a Board finding. 6. 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 15-8-503, C.RS. 1984, as amended, This form has heen approved by the Mined Land Reclamation Board pursuant to section 34-32.5-III,GR.S., of the Colorado Land Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this jorm shalt result in ~ „ voiding anypermitissued on the altered or modified jorm and subject the operator to cease and desist orders and civet penalties for operating without a permit pursuant to section 34-31.5-123, C.R.S. Signed and dated this ~+ r ~~ day ApplicanUOperator ~t/~ /.~iyi~l. By. ~y ,( ~dTrnT.i.v~ Title: ~^~`~' State of ~ [7~~Q /2~~(7 ) /~ ) ss. County of ~17~/Yl~s ) ~' 7iCrY'G - -.. Y s,~ t~ , '~'~ i~ If Corporation Attest (Seal)' `,, ~'' By: C cr az or Equivalent own/ tvlCounty Clerk The foregoing instrument was acknowledged~~ b~efo~re me this ~~ day of ~' n 1/ EI`Yl~'>~!2- z~x , by ~~N~l ~r~`~rE~uN as~zr.~rr-<k ~l~N~~of ~t~Tl~ntv~otvS~>zuci My Commission expires: ~/2g~'2(~(~ BF IN BLUF, INK Mamhi~thsretvsfoma`{p,ysmuaion 111 ff:. tir = rJ N