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RECEIVE® <br />~- <br />Certificafion: <br />JAN 0 3 2006 <br />Division of Minerals and Oeolegy <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) inexistence at the time <br />this application is filed, and located within 200 feet of the proposed affected area have been identified in this apphcation <br />(Section 34-32.5-115(4)(e), C.RS.). <br />2. No mining operation will be located on lands where such operations aze prohibited by law <br />(Section 34-32.5-115(4)(f), C.R.S.; <br />3. As the applicanUoperator, I do not have any extraction/explorntionoperations inthe State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials <br />(Section 34-32.5-120, C.R.S.) as determined through a Board fmding. <br />4. I understand that statements in the application aze being made under penalty of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />This form has been approved iSy the Mined Land Reclamation Board pursuant to section 34-32.5-711,C.RS, ojthe Colorado Land <br />Reclamation Ad jor tke F.avadion of Construction Materials. Any alteration or madtJtcation ofthis form skaUrcsuU in voiding any <br />permit issued on the ahercd ar modified form and subject the operator to cease and desist orders and civil penalties for operating <br />without a permit pursuant to section 34-3b123, C.RS. ~~ <br />r <br />3 °~ da of Oc X06 c! 1d a ~ ~ ~ '''' ;, <br />Signed and dated this y , <br />:~` ~. <br />EnCana Oil & Gas (USA), Inc. <br />ApplicanUCpemtor or Company Name <br />Signed: ~~ / <br />Q a~ r!i/~ .~ ill4,~t t <br />Title:.~,iv"'br~c4-r., • F~ <br />State of l_.tJ 1U I'~,clo ) <br />ss. <br />County of ~ ~, v e.r ) <br />'.• _ 3 <br />J . cr <br />If Corporation Attest (Seal) , ~ •` ~ ? `~ <br />' fJ7 `~S 'v~,: <br />- ~,~ <br />Signe . <br />Corporat ecretazy or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this ~r ~ day of ~ C~ J ~ <br />by D~ ~ ~ ~ ~ S- ~"~ eM.Ke. as ~~ol' ~ e., - , ~ - FG-c~ of Encana Oil & Gas (USA), Inc. <br />6 ~ ~~ <br />otary Public <br />My Commis <br />JUDITH B. SISNEROS <br />SIGNATURES MUST BE IN BLUE INK NOTARY PUBLIC <br />STATE OF COLORADO <br />m:~~n~~.ar~,~w+;m. t t z a« (o~nenooa) <br />My Commlaelon Explrea 03/77/2008 <br />