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8- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has rrd;tthe minanum requirentems of <br />the following terms and conditions: <br />I. To the best ofmy Imowledge, ail significant, valuable and permnnemman-made strucpae(s) in existence at the time tiffs <br />application is filed, and located within 200 feet of the proposed att'ectod area have been identified in this application <br />(Section 34-32.5-1 IS(4xe), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law <br />(Secton 34-32.5-115(4)(f), C.RS.; <br />3. As the applicant/operatar, 7 do not have arry extractiaolexploration operations in the State of Colorado currently in <br />~~olation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials <br />(Section 34-32.5-120, C.RS.) as determined through a Board finding. <br />4. I understand that statements in [he application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Thirjorm has bterr approrcdlry Ott Afbrm' Land Readanradar Board prruww[to recriar #32~III CR.~, ofate Colorado Land <br />Redanration Ad jot the F.raraeaiox ojCondrurriaa Maanids. My aherdion or modifie~'on of atirjorm shall reaaC is voidueg any <br />permirirsxedon dre alined ar modifudjorm and snhjecrdte operator toeeore and desist ordtrs andciri[peaadtresjoraperabngMV/eaur <br />a permit pursumato section 331.5-113, CRS. <br />signed and dated this 3 day of ~ ~.QO~.o .~~o a`~ ~ T ~ ^~~' f~~~., <br />Q a. a~o~r Co ,~C, If Corporation Attest (seal) -~ ;~ ~ ~~ •o o' <br />Appl ci' arrt/Uperator or nparry Name ? o ':o ?.~ ~~1 Q; '~ <br />Signed: ~ <br />Tile: Y~.~~C1Q,!\~ <br />State of ~~oro~e0 <br />ss. <br />County of 0.r~L 1 <br />The foregoing instroment was aclmowledged' <br />by~(R.C~~ CZ~~~.v~ as <br />rr/ <br />ilrate Secretary or Equiva <br />TowolCitylCounty Cleric <br />`~C. <br />My Commission expires:-Fv~e~~r~(~ <br />M:hrinkhceMrwm!Cauwwm ~~2doc (Appaeed OS/11(3005) <br />SIGNATURES MUST BE IN BLUE INK <br />