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RECEIVED <br />' - ~ - JUL"P.~2000 <br />Certification: (~ '~'~~ <br />Division of Minerals and Geology <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 />4. To the best of my knowledge, all significant, valuable and permanent man-made struMUre(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-t IS(4}(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations aze prohibited by law (Section <br />34-32.5-I I5(4xfJ, C.R.S.; <br />3. As the applicant/operator, I do not have any extraetionlexploration 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 are 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.R.S. <br />Signed and dated this -~ n~ day of Tu ~.. -~oo~_. <br />Po.~c~R sn,~y ~ .r,~,v ~~r <br />ApplicanUOperator or Comp~Nam-~e <br />Signed: -' 1 <br />Title: .~~6. S i0it . / ~- <br />]f Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />Staten` F -u ~ ) <br />/~ ) ss <br />County of ~~~o S o ) <br />The foregoing instrument was acknowledged before me this q_(_ day of UJ.J , <br />by~~P ,~~ as ~ir,~./rr..~f of v c~ <br />otary Public <br />MY Commission Expired <br />8/ypD02 <br />My Commission expires: <br />SIGNATURES MUST BE IN BLUE INK <br />w~wrnsru~vsrortn+swzacorz.,~rr ovrasv <br />