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<br />Certification• <br />- 6 - <br />Ace as authorized representative of the applicant, I hereby certify that the operation described <br />bas met the minimum requirements of the following terms and caaditioas: <br />1. All aeceasary'approvals from local goveraent have been applied for <br />(Section 34-32.5-110(1)(a)(viii). <br />2. To the beat of my knowledge, all significant, valuable and permanent man-made structure(s) <br />in existence at the time thin 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(a)(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 laa <br />(Section 34-32.5-115(4)(f), C.R.S.). <br />4. Ae 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 Laced Reclamation Act fox <br />the Hxtraction of Construction Materials (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements is the application are being made under penalty of perjur} <br />and that false statements made herein are punishable as a Claea i misdemeanor pursuant tc <br />Section 18-8-503, C.R.S 1984. <br />Signed and dated this 4th day of <br />Rio Blanco County Road and Bridge <br />Richard Ullom <br />(applicant/ \~~ r - <br />Signed: I `n ~ a~'~F~ - <br />Title: SllPerV].SOr <br />State of Colorado ) <br />ss <br />county of Rio Blanco ) <br />June 1995 'J <br />If Corporation Attest (Seal) <br />Signed: <br />Corp rate Secretary or Equivalent <br />Town/City/Count~Clerk <br />The foregoing instrument was acknowledged before me this 4th day of June 1998, <br />by Richard D. Ullom as Supervisor of <br />\• <br />07/19/97 2821FC0.110 <br />Rio Blanco County Road & <br />Bridge Department <br />. ~d ld (/,steCii..An/ <br />. Notary Public Meeker4 CO <br />My Commission expires: 11/5/99 <br />SIGNATIIRES M[TST BE IN BLIIE INR <br />