Laserfiche WebLink
8- <br />Certification; <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the mimhnutn requirements of <br />the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) inexistence at the time this <br />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.R.SJ. <br />2. No mining operation will be located on lands where such operations are prohibited by law <br />(Section 34-32.5-115(4)([), C.R.S.; <br />3. As the applicanUoperator, I do not have any 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 <br />(Section 34-32.5-120, C.R.S.) as determined though a Board finding. <br />4. [understand that statements in the application are being made under penalty of perjury and that false statements made <br />herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />This jorm has been approved by the Mined Land Reclamation Board pursuant to secdan 34-32.5-111,C.RS., ojthe Colorodo Land <br />Reclamation AM jot the Extracton ojConstruclion MoterioLs. Any alteration or modification ojthis jorm shall result in voiding any <br />permit issued on the aheied or modifiedjorm and subject the operator fo cease and desist orders and civil penalties jot ope{pting~iWhout <br />a permit pursuant to section 34-32.5-123, C.RS. ~'' Fa 4~fJ,!? t ~, ., <br />Signed and dated this ~ ~ day of Feb~~~~0.V~~ ~~~~ <br />McAtee Construction Comnany. <br />ApplicanUOperator or Compatry Name <br />Signed: ~i Lug..,. ~ c X'~--w- <br />Title: Vice President <br />Slate of Colorado ) <br />ss. <br />County of Logan ) <br />If Corporation Attest (Seal) <br />r ., <br />~ <br /> <br />y /+ <br />V <br />/~ <br />~ y F <br />~ ~ , L~. <br />~i y <br />~1 <br />rrs <br />` ~ QI g ;' <br />>~y <br />~ 1 <br />~i i r~~tir«~•y t,~ ~" <br /> <br /> <br />Signed: 1\~ <br />~f Corporate Secretary or Eq(rivalent <br />Towm/City/County Clerk <br />The foregoing instrument was acknowledged before me this ~ I day of {~Q~f-fa-r~~ ~~ <br />by William G. Lauer as Vice President of McAtee Construction Commanv. <br />JODI DIORIO ~~- ~ <br />t~TA€iY PUBLIC I No Public <br />STATE OF COLORADO <br />h1y ComtMsslon Errlres Jtmuary 29, 2~8 My Commission expires: ~ I ~~` p~ <br />SIGNATURES MUST BE IN BLUE [NK <br />M:~minWme\vyramn~Cortsvuelim 112.da (Approved Os/1 I1200s) <br />