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~~% <br />i " <br />s <br />Certifications <br />-6- <br />As an authorized representative of the applicant, I hereby certify that the operation described <br />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 structure(s) <br />in existence at the time this application ie filed, and located within 200 feet of the <br />proposed affected area have been identified in this application (Section 34-32.5-115(4)(e), <br />C. R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the <br />permit boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law <br />(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 state <br />of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for <br />the Extraction of Construction Hateriala (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements in the application are being made under penalty of perjury <br />and that false statements made herein are punishable ae a Class 1 misdemeanor pursuant to <br />section 18-8-503, C.R.S 1984. <br />Signed and dated this ~_ day of ~ me-~-. , 9 9a <br />G'- ~-/ C~ ~1 ~ <br />Applicant/ rator <br />Signed: G L_ X ~ °/~ ~- <br />Title: Owe O~II--~ <br />if Corporation Atteffit;(Seal) <br />Signed ~. ~: ~~~ <br />Corporate Secret o Equ <br />Town/City unty Clerk <br />State of CO~argdp ) <br />r ) es <br />County of CG9~Q ) <br />The foregoing instrument was acknowledged before me this f~ day of 1~Qrc ~ , ~,QQ~,, <br />by ~(e~n H. 6af(QOas as Pres~deak o~ OoerQdr' of ~ os l'1'laeo„~Y Tn,~,. <br />P~jjH,WH%~~~~~i~ pp <br />lF '~. ~.~0_~LGC2. _ <br />ur,~ <br />~~TgRy.: Notary Public <br />-Q~-~-Q- Hy Commission expires: c2 L]/99 <br />/'UBLIGr~ <br />o .~ <br />~nC~ni~Oe:PO~~`\` SIGlU1TORE5 MOST EE IN SLUE INR <br />01/02/96 2821FC0.110 <br />