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<br /> <br />l~ <br />- 7 - <br />C rtification: <br />azed 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. 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(9)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by <br />law (Section 34-32.5-115(9)(f), C.R.S.; <br />3. As the applicant/operator, I do not have any extraction/exploration 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, C.R.S.) <br />as determined through a Board finding. <br />9. 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 18-6-503, C.R.S. _~~~~~~~;;~„!i <br />Signed and dated this ~ day of !Je.(Paxbe( ~_. <br />Q GA t~ra~.(~fs <br />~plicant/Operator Or Company Name <br />Signed: l !l/1.f <br />Title: PfPS1~Pn-1 <br />State of ro(orac~n ) <br />County of ( dlattPP ) <br />ss <br />If Corporation Attest (S <br />SEAL = <br />.~ ,; <br />;~C 0 R AQ~~`~~, <br />Signed: n /~a~": !4 a ~ ~n ~r~.T <br />Corp ate Secretary or Equivalent <br />Town/City/County Clerk <br />p ti- 149 <br />The foregoing instrument was acknowledged before me this 8 day of l7P C2 m ber , <br />by (.~'10.r~Pa K, MurO~ as rfCStriC/11 of ~~ Prn~ur:fs <br />Notary Publicf <br />My Commission expires: `>'/off//~/ <br />SZQTTTQRES MAST BE IN SLi3E INR -°_ ~' ~~. - <br />• ~. . <br />04/25/97 2823FC0.112 _„~ <br />