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• <br />-6- <br />Certification: <br />Ae 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 beet of my knowledge, all significant, valuable and permanent man-made structure(s) <br />in existence at the time this application is 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 Materials (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 hereia are punishable as a Class 1 misdemeanor pursuant to <br />Section 16-B-503, C.R.S 1984. <br />Signed and dated this _~ ~ day of YV1 0. ~' C ~ , ~~ <br />Sores c W ~ C ~` ~ o ~ ti'~- ~ Ro 4~ ~ Dv ~ ~~~ I f Corporation Attest ( Seal ) <br />licant/Operator <br />Signed: I\ c. .. ~ 1 t <br />Title: S. ~ ~P ~ ~ r S r~ r <br />State of C O ~ o Y c. C 0 ) <br />County of ~~ ~.~ ~ ~ ) <br />ss <br />Signed: /Efp~. nc ~ ///~Y~/I~~in ) <br />Corporate ecretary or Equivalent <br />Town/City/County Clerk <br />Jr <br />The foregoQing instrument was acknowlgdged before me this 31 day of ~IA/LCN , ~, <br />R dc~ RPJYi t~(~is~ /K~~I-B S/ufP.r~/v~~~sor <br />by f5 f i.S+ P~ A ~ ~ 2A")L~0 / as l ".f~U/YI~UL L)(f/.f .~2 o i C <br />Gwc;vUU~YN RUSE ZHRUUH ,~ <br />Notary Public, Colorado otary Publ' <br />My Commission Expires 10/2/99 <br />My Commission expires: /~%-~C/~ <br />SIGNATURES MIIST SS IN BLIIS INR <br />01/02/96 2ffi1FC0.110 <br />