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• <br />Certificatios• <br />-~- <br /> <br />Ae an authorized repreeentative 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 beet 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 ouch operations are prohibited by <br />law (Section 34-32.5-115(4)(f), C.R.S.; <br />3. As 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 Materials (Section 34-32.5-120, C.R.S.) <br />as 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 as a Class 1 misdemeanor <br />pursuant to Section 16-8-503, C.R.S. <br />> ~ <br />Signed and dated this _ /l day of , <br />Hall-Irwin Construction Co. <br />Applicant/Opera/t/or <br />Signed: _/ <br />Title: V(`~,~,p4.~ `.ndl>>.,~4,'Vl~ <br />State of \l7~ll~r~,j~,_) <br />~~ ~ ) 65 <br />County of ~\ 1S? IY~~{!`~ ) <br />If Corporation Attest (Sea_l)~e <br />G(~iN <br />Signed: ~ <br />Corpor to Secretary or Equivalent <br />Town/City/County Clerk <br />Thenforeg1oing~~in~s~t~ (r~ument was acknowl`eldged bn/efore me this ~~ day11 ofp ~, <br />by ht~d A l'~U-~lX _ as U UC_ 4 `1~9,J]~P',.c~ of 11N,1~~ -,~, n.Rm ~1~ ~P4'.uti~\L~ <br />~ .( <br />~ `~ <br />. ~; <br />~>_~~~~ <br />Notary Public /~ <br />My Commission expires: ~Zglg~ <br />or/oz/~ zszsFCO.rrz <br />