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- 6 - <br />tificatioa: <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 34- <br />32.5-115(4)(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 />4. 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 1984. <br />Signed and dated this •~ day of l/(C[~ aCC~1 <br />~~~/, G,Z (~- <br />• <br />i ' <br />If Corporation Attest (Seal) <br />Applicant%Operat <br />Signed: <br />Title: <br />Signed: <br />State of ct''G'%(<C! ~' ) <br />/~ .~ ) ss <br />County of L i[~( L~ ~~ I <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this J day of 7~ ~ sir ~~, <br />by ~•~ct~El.( f ~I:~,~G~'G6 as ~`lJK~FhS of ~' •.~ - ~t <br />%~dotary PuDl~.ii~ , <br />My Commission expires: ~~ - _s~C <br />• SIGNATIIRES M[TST HE IN SLIIE INK <br />04/25/97 2821FC0.110 <br />