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-6- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the,rrin;m„m requirements <br />of the following terms and conditions: <br />1. All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(a)(viii) <br />2. To the best of my knowledge, all significant, valuable and permanent man-made stmcture(s) in existence 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.). (NOTE: For 110 ogerations, the affected area includes all lands delineated by the <br />permit boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.RS J. <br />4. As the applicant/operator, I do not have any mining/prospecting operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Constnlction Materials (Section 34- <br />32.5-120, C.RS.}. <br />5. I understand that statements in the application are being made under penariy of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. 1984. <br />Signed and dated this ~ day of J `^-"`'~ ~. <br />/ ' //' ~~ ~ ff Corporation Attest (Seal). <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of.~ ~l n ~ a~ h ) <br />ss. <br />County nf -~-,~~riGR- ~ P ~ ) <br />The foregoin instrument was acknowledged before me this ~ day of ~ U Yl ~ D , by <br />,, - <br />,, <br />~:-: <br />_ _ - ., <br />A ~ __ N - blic <br />'fi'r. ~ ~, _ ~~`.:~~~~ My Commission expires: ~ - ~ b - [Z`~ <br />,..... SIGN:4`I'URES MUST BE IN BLUE INK <br />M~mm\shace\vsfo~ms\Cms4uGim110 (10/15!2001) ' <br />Title: RN/l) /V ~~_. <br />~~ <br />