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<br />Certification: <br />-~- <br /> <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. To the beat of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application ie filed, and located within 200 <br />feet of the proposed affected area have been identified in this application (Section 34- <br />32.5-115(4)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by <br />law (Section 34-32.5-115(4)(f), C.R.S.; <br />3. Ae the applicant/operator, I do not have any extraction/exploration operations in the <br />State of Colorado currently in violation of the provisions of the Colorado Land <br />Reclamation Act for the Extraction of Construction llateriale (Section 34-32.5-120, C.R.S.) <br />ae determined through a Board finding. <br />4. I understand that statements in the application are being made under penalty of <br />perjury and that false statements made herein are punishable ae a Class 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this ~ day of , <br />Hall-Irwin Construction Co. <br />Applicant/Operator <br />signed: =_:~j <br />\1 T' <br />Title: V ~f. e ~/~4~~..Z~.4 v~ <br />State of C (1~' rn(~~~, > <br />~~~ ) ss <br />County of ~\ 1 y f{~~"(~~ ) <br />if Corporation Attest (Seal)~e <br />Signed: Gt~/`~ <br />Corpor to Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this ~^ day of ~~? , <br />by ~t7C 1`=UJLX as V UC 4 `/~C (lxf'~.a~i of ktc.~:` , n.Clm ~ ~ :P.Ffiti~ L1 <br />i , ( <br />I``1 ~ ~~.~ <br />~~W~~~ J ~') ~ <br />Notary Public 1 <br />Hy Commission expires: ~~~~~~ <br />01/02/% 2823FC0.112 <br />