Laserfiche WebLink
-~- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the <br />following teens and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.5-! 10(l)(a)(VIII). <br />2. To the best of my knowledge, all significant, valuable and permanent man-made stmcture(s} in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-I 75(4)(e), C.R.S.}. (NOTE: For i 10 operations, the affected area includes ail lands delineated by the permit <br />boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.R.S.). <br />4. As the applicandoperator, I do not have any mining/explomtion operations in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S J. <br />5. I understand that statements in the application are being made under penalty ofperjury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. 1984. <br />This form has been approved by the Mined Land Reclamation Raard pursuant to section 34-32.5-IIO,C.RS., ofJhe Colorado Land <br />Reclammion Act for the Extraction ojCoratruction Materials. Any alteration or modification ojthis jorm shall result in voiding <br />any permit issued oir the oltered or modified jorm and subject the operator to cease and desist orders and civil penahies for <br />operating without a permit pursuant to section 34-32.5-123, G R.S. <br />Signed and dated this ~O ~~^ day of `l~\\}~ It_C~ ZOO <br />pie~ ~ $ E E l 1r) If Corporation Attest (Seal) <br />or <br />Signe <br />Title: Dw NEK -- <br />State of ) <br />ss. <br />County of _ ) <br />'fhe foregoing instmment was acknowledged before me [his <br />_, by _ as <br />M:Amin\sharc':vsforms\Cnn>Imcfion 110 (Approved OS/I (/2005) <br />Signed: <br />Corporate Secretary or Equivalent <br />TowniCity{County Clerk <br />day of <br />of <br />Y --yy-- iiy~~ ^~y~~ <br />My Commission expires: L1t~P ~YIJI o[t-() / -_ <br />