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<br /> <br />- 6 - <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. All necessary approvals from local government have been applied for <br />(Section 34-32.5-110(1)(a)(viii). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application is filed, and located within 200 <br />feet of the proposed affected area have been identified in this application (Section 39- <br />32.5-115(9)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands <br />delineated by the permit boundary.) <br />3. 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 />9. As the applicant/operator, I do not have any mining/prospecting 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, <br />C.R.S.). <br />5. 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 18-8-503, C.R.S 1989. <br />~~ <br />Signed and dated this ~~ day of ~4 v4 c ry j 9 99 <br />~Orn e/ ~n,.~KS/ nniS/ i-,. c~Ton SiVC <br />Applicant/Operator <br />Signed ~~ ~ o ~-.Qc~ <br />Title: ~1- a s, c% _."~ <br />If Corporation Attest (Seal) <br />` ~ ~ <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of ~~ /7 ~n ra ~I n ) <br />// ) ss <br />County of N/„ir~,/ ) <br />The <br />f <br />o <br />regoin <br />g <br />i <br />nstr <br />ument was acknowl <br />e <br />dg <br />e <br />d <br />b <br />e <br />fo <br />re me this ~ d <br />ay o <br />f ~~ <br />CC <br />~~ <br />nn <br />1~ <br />'~('' <br />(p~ <br />/~, <br />by ~1~~ )~/~~j ~/ <br />y <br />1 <br />~ <br />n <br />/ <br />n <br />~ <br />as~lt-~~/~X.VU 1 <br />~, <br />of W(~ M A ^ ~,~,, r,. n m <br />,, <br />~ <br />~~6G~f/~V ,,, I <br />~_ <br />.~ ~ / <br />,NCtary Fub: <br />My Commission:expires: c ` <br />n f- <br />SIGN!-TURE9 M[7ST BE IN BLIIE ZNR/`' --"~~~~c± <br />~~~I~ <br />04/25/97 2821FC0.110 <br />