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-~- <br />Certification: <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 best 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. 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 />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 as a Class 1 misdemeanor <br />pursuant to Section 18-6-503, C.R.S. n - , <br />Signed and dated this 7~L day of t~ , `-~~. ,., <br />.. ~ -~ <br />- ,, -~ <br />(( f( <br />~, 1--^ ~~^ ~S r...~~F,a,... ,no..,~ If Corporation Attest (Sea'1) , ..- <br />Applicant/ rator Company Name / // <br />Signed: Signed: ~~ LZZI/ <br />, i <br />Corpo ate Secretary or Equivalent <br />Title: ~c...,, ~ Town/City/County Clerk <br />State of <br />sa <br />County of <br />The forlIego'' ing instrument was acknowledg(e~d before me this ~~~ day of (~ ~~_, <br />by CJL.I..C-~{ ~A/] asVi(p-Clle.Oi('~!/Tf of '~YLJ-~ALJi1'`- <br />~pa~u1 A6,IJ <br />Notary Public <br />My Commission expires:~D h(?t/I a~~~ 8~') <br />SIGNATURES MUST BB IN SLVE INR <br />01/02/96 2823FC0.112 <br />i..# _. _.. '.v: _i.i.,........_..6. _..m.1s..~~:_:._-~n;, ~..~ _ .. -. '. :: .n ~. -_ ~: i ~;::.`.:;"`:: .~~~.>t~. ~.A=a....~.. nom,. ~~ <br />