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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 />requiremems of the foflowing terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) inexistence 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 34-32.5-115(4)(e), C.RS.). <br />2. No mining operation will be located on lands where such operations are prohibited by law (Section <br />34-32.5-115(4)(f), C.RS.; <br />~. As the applicant/operator, I do not have a~ 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.RS.) as determined through a Board Ending. <br />4. I understand that statements in the application are being made under penalty of perjury aad that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />' YF <br />this . _ day of UMe- ?EdJ~ <br />LLG If Corporation Aitest (Seal) <br />Signed: , ~%%~/ Signed: <br />Title: ~usre0¢~l~gek't" , rhainaq.~tc~ [zrt`(+'~Qr <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of P~Co/d~Q <br />,,` ) ss. <br />County of ~ f ~a2~c <br />The foregoing instrument was acknowledged before me this ~~ day of Ji,r.t<e_ . 7~S by <br />_ (Jo~t~fe s S.vvtdns~ as Wlawa~ettG Pa,.°(nei( of 6uztv¢~ , LLG <br />Notary Public <br />My Commission expires '•..;~~~~~...`~- <br />F'n' CON8A18810N E7'tPIRE8: <br />.IlN1E ti, ZOai <br />SIGNATURES MUST BE IN BLUE INK <br />M:~~~Hr~w ru.a~ <iwisrmoit <br />