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• -~- • <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation <br />described has set 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 is 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 as a Class 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this ~ 5~ day of ~~~ ~~ ~ ~. <br />Grand .lnnrtinn P;(,_y Sunply (ln_ <br />Applicant/Operator or Company Name <br />If Corporation Attest (Seal) <br />signed: ~/" /.G-ci ~~+--~ <br />Title:. President <br />State of Colorado ) <br />signed: ~//JG~+ienJ .iY O/lu/.,tJ ' <br />Corporate Secre~al=y cIr17,uivalent <br />. Town/City/County Clerk^ <br />ss <br />County of Mesa ) <br />The foregoing instrument was acknowledged before me this ~ day of ~)iti+~ ,~, <br />by Marie Tivning as President of C:ranri .ii,nrr;nn Pipe &~„nnly Co. <br />N terry Public <br />My Commission expires:) I ( ~J ~~OI <br />SIGNATORES MOST SE IH ffiIIE INR <br />01/02/96 28YiFC0.112 <br />