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<br />-s- <br /> <br />Certification• <br />As an authorized representative of the applicant, I hereby certify that the operation <br />described has met the minimum requirements of the following terms and conditions: <br />1. This mining operation will not adversely affect the stability of any <br />significant, valuable and permanent man-made structure(s) located within two hundred <br />(200) feet of the affected lands. (However, where there is an agreement between the <br />applicant/operator and the persons having as interest in the structure that damage <br />to the structure is to be compensated for by the applicant/operator (Section <br />834-32-115(4)(d), C.R.S. 1984, as amended), then mining may occur within 200 feet. <br />Proof of an agreement must be submitted to the Office prior to the decision date.) <br />2. Ho mining operation rill be located on lands where such operations are <br />prohibited by law (Section 34-32-115(4)(f), C.R.S. 1984, as amended); <br />3. As the applicant/operator, I do not have nay mining/prospecting operations in <br />this state of Colorado currently in violation of the provisions of the Mined Iaad <br />Reclamation Act (Section 34-32-120, C.R.S. 1984, as amended) as determined through <br />a Board finding. <br />4. I understand that statements in the application are being made under penalty <br />of perjury and that false statements made herein are punishable as a Class 1 <br />misdemeanor pursuant to Section 18-B-503, C.R.S 1984, as amended. <br />Signed and dated this ~ day of -r a ~c1G <br />Western Gravel, Inc. <br />Applicant/ rotor If Corpora//tion Attest (Se/ayl,)~~ ~/~ <br />Corporate Secret or Equivalent <br />Title: Manager Town/City/County Clerk. <br />State of l ~f1I(iYGi(~cl ) <br />/~-~ /I ) 66 <br />County of I 1 1 GY1-I YOS L. ) <br />The foregoing instnmsent was aGmowledged before me this ~~~~day of {7iuG.r- , L~JS~i <br />by ~ ( iQ.n W~ ISLN~ as mC~ rr~G-2 ~ of 1l X'S ~°, i'1 l 1 r1~.~,r+ ~ ~Il~ <br />~ 1,1. . ~' L.~e; L~ <br />Hot Public <br />c <br />_ My Commission expires: n- I ~ -nJ ~_ <br />2b23F <br />(10/14194) <br />