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-~- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. To the best of my ]mowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected azea have been identified in this application <br />(Section 34-32.5-115(4)(e), C.R.S.). <br />2. No mitvng operation will be located on lands where such operations aze prohibited by law (Section <br />34-32.5-I li(4)(f), C.R.S.; <br />3. As the applicandoperator, I do not have any extraction/exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.5-120, C.R.S.) as determined through a Board fmding. <br />4. I understand that statements in the application aze beine made under penalty of perjury and that false statements <br />made herein aze punishable as a Class ]misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this ~~ day of Fi/b1'uG t'Y 2t~~1 <br />ApplicantlOperator or Company Name <br />~, ~ <br />Signed: \~a-- ~ -_ \~~,~, 1,~---~L <br />Title: ~r^2Sidefit <br />State of l~ o~ora;ln ) <br />~// ) ss <br />County of ~0(pfyv~ ) <br />The foregoing instrument was aclmowledged before me this ss~. day of / C.GJFUGi r ~ 0 0 5/, <br />by ~:~'e.l I.l- ~-I~n+ as ~+,eS~clen,I' Of ~~~~P ,,Qhro ~~ QrR.. <br />\~ - •yv <br />~N <br />t <br />t <br />Notary Public <br />G 'O <br />~o <br />9~:•.VBL~ . f, <br />~ Op COVOQ My Comrnission expires: ~-~~ - ~ ~ <br />My Corrudssion Ei~itesCl~11/1006 <br />SIGNATURES MUST BE IN BLUE INK <br />Nf:VN LN~BDLN1WFOR~15Q833C012AFF 10/17/GI <br />