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Certillcation• <br />-6- <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of <br />the following terms and conditions: <br />All necessary approvals from local govemmrnt have bern applied for (Section 34-32.5-111(I)(a)(I?Q); <br />2. This entire mining operation will not affect more than 30 acres; <br />3. This mining operation will not adversely affect the stability ofany significant, valuable and permanent man-made <br />structure(s) located within two hundred (200} fee[ of the affected lands. (However, where there is an agreement between the <br />applicanUoperatorandrhe persons having an interest in the stmcmre that damage to the stmcture is [o be compensated for <br />by the applicanUoperator (Section 34-32.5-I I5(4)(e), C.R.S. 1984, as amended), then mining may occur within 200 feet. <br />Proof of an agreemrnt must be submitted to the Of£ce prior to the decision date.) <br />4. No mining operation will be located on lands where such operations aze prohibited by law <br />(Section 34-32.5-115(4)(f), C.R.S. 1984, as amended); <br />5. As the app]icanUoperator, I do not have any mininglexploration operations in this state of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extrac8on of Construction Materials <br />(Section 34-32.5-120, C.R.S. 1984, as amended) as determined through a Board finding. <br />6. I understand that statements in the application aze being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984, as amended. <br />This form has been approved by the Mined Land Reclamauon Board pursuant to section 34-32.5-111,GRS., ojthe Colorado <br />Land Reclamation Act for the Extraction ojConstruction Materials. Any alteration or modification ojthis jorm shall result ~,;,, <br />voiding anypermitissuedontheatteredormodifredjormandsubjecttheoperatortoceaseanddesistordersandcivupenaltJes ""r,, <br />for operating without a permit pursuant to section 34-32.5-123, C.RS. <br />iJ ~ 1 <br />Signed and dated this G ~ day of .. - N° ~`~~'-~- Zo-D4 ~ ,;?' ( S - <br />~ ;~ <br />~~"~ If Corporation Attest (Seal)?'-,, ^'' ~}" ,~ <br />ApplicanUOperator "`" <br />t-c~•,- ..;, <br />By: <br />Title: '~' <br />sate of ~~n RADC7 1 <br />ss. <br />County of ~~)~~ ) <br />Equivalent <br />The foregoing instrument was acknowledged betbre me this -L1---day of ~,' nU 6)'Vl~'~~/2- Z , <br />by~/y~/ E2fl~ttSLIN as~{~ZS[C~~~~-~2-of ~'/~~~[ZN~DNST2C/_C (t` <br />My Commission expires: ~~ 0~2O / ~y eQ <br />SIGNATURES MUST BE IN BLl)F, IVK <br />r4N( <br />M:'v,tinsMrc'nsibms`,Conemuaiuni l l (Appmvttl OS%1 L21x15) <br />