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-8- <br />.~ <br />As an authorial repre3errtative ofthe applicant, I herebyoertify that the operatimr described has met the minimum regrrirernents <br />of the following terms and rnnditions: <br />1. To the best of my Imowkdge, all signiticam, vahmbk and pem~anent man-made sttudure(s) in existence at the time <br />this a~licatiorr is filed, and located within 200 feet ofthe proposed affected area have bees idrartifiedm this application <br />(Section 34-72.5-I IS(4xe), C.RS.). <br />2. No mining operation wiB be located on bards where such operatiests are pmlu'bited by law <br />(Section 3432.5-115(4xf), C.R.S.; <br />3. As the applic,~u/apetator, [ ~ rwt have any exttactionlexpkaation operations in the State otColorado currently in <br />viohrtion of the pmvisiau of the Cokmrdo Land Reclamation Ad fm the Extraction of Constmai~ Materials <br />(Section 3432.5-120, C.RS.) as detC(irtiIICd through a Board fn>ding. <br />4. I understand that statements in the applies are being rtmde under penalty of perjury and that false staternerds <br />made lxrein are punishable as a Class 1 rnisdenxanor pursuant to Sedien 18-8-503, C.R.S. <br />Tlrh: fenw bur bear ayposeat b~ thsATheet Lmd Faafeeutlsa dnnl yrvsraaC a mdar 3l-32S-ll;CRS, elate Cehrrwlileat <br />Rai/ewedwrAdfirdFeEeretXerefwM Agnwe~s~efrblsfawsieDreraBlnwlNwd~l <br />Perwlf laswe+r oa the aEksed err wai~dlonw aeJ ts~bfAd the eyereror err onar eKl /asst eri&ra err/ dM yddtles jor eperadig <br />rrdrhart • perwir parswwt b sedlsw 31-i25-/?3, C1LS <br />Sigrid and dated this ~T ~I day of ~D~~ BED ~00 <br />Applicantl0perator or Company Name <br />Signel:~~ ~ <br />rte, r>7 aqe" <br />Title: <br />If Corporatism Attest {Seal) <br />signed: <br />Corporate Secretary or Equivalent <br />Towr/City/County Clerk <br />State of ~-U~{~r1 ~IJO ) <br />AA ) ss. <br />Cswnty of ~~ 5 /ti]i77taS ) <br />The foregoing ir>atmment was ackrtowledgtx, before me this _~ day of / /UU€/I~11,GI ~D~P <br />_., by FiP.y-hhlcCeorxJ~ S ,1,~~0°u /2j,¢h~oe.T of/rune SAnnz;! lr4Na/ LLG <br />a:=-~ ;.:-. <br />. <br />;• ~', ~ Notary Public <br /> • <br />' <br />-_ `~~r- _ ~F <br />,~" <br />- My Commission expires: O ~ ~ 0009 <br /> <br />;~~','*•~~`' ~ "'~-`~ <br />. ` SIGNATURES MUST BE IN BLUE INK <br />w - '~ in.as(~vprneaosn~rmos) <br />