Laserfiche WebLink
-~- <br />Certification: <br />Ae 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 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 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 />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 ae a Claee 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this ~ day of ~G~,rT , /51~G <br />The Denver Rrick <br />ant/Oaerator or <br />Signed: <br />Title: <br />State of (~ol.o2A L1O ) <br />y~~ se <br />Covnty of L.UUGC]QS ) <br />If Corporation Attest .(Sa+a j <br />Signed: <br />Corporate S rotary or Squivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this Z~ day of AUC-y~~ 9-6 , <br />by UARR4 C • SI}A FHYL, 1P ae D2a5~ b~c+~- of "M6- ~0 <br />Notary putilic,_.•_ <br />My Commission es~~ <br />, <br />SIGNATURES MUST BS IN BLUE INR <br />01/02/96 1B73FC0.112 <br />