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~RFCFIVFG <br />. ! -'- • OCT pg 1991 <br />Certification: <br />r?i~•is~cn cr • <br />As an authorized representative of the applicant, I hereby certify that the o~{~~rE'ion(;~~;`~~ <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 ie filed, and located within 200 <br />feet of the proposed affected area have been identified in this application (Section 34- <br />32.5-115(4){e), C.R.S.). <br />Hy commission expires: / ~-U ~ - g 8 <br />2. No mining operation will be located on lands where such operations are prohibited by <br />law (Section 34-32.5-115(4)(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 3Saterials (Section 34-32.5-120, C.R.S.) <br />as determined through a Board finding. <br />4. 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 18-8-503, C.R.S. <br />c' <br />Signed and dated this o~L day of Y b =~~1 , <br />John Slinian & Butch Southway dba JBCO Y If Corporation Attest (Seal) <br />Applica~nty~,/OpelIrator or Comp/a~ny Name ,} <br />Signed: `~'""~'~V1 ~ P ~~` ~)~-.'~~^^~V Signed: <br />Lloyd V~&ack~r Barnhart Corporate Secretary or Equivalent <br />Title: Consultant & Agent Town/City/County Clerk <br />State of COIU ~~ ~~ ) <br />{1 f ) s s <br />County of I iti ~h ( r~ ) <br />The foregoing,/instrumenht was acknowledged before me this L3 day of ~~~/ , / ~ 9 7 <br />by LLoYC7 (/, rlJ~k C~lzr(HA~t(ys ~'onlSe.C7.fuF Ci4Nr of <br />Not Public <br />SIGNATURES ISUST SE IH BLUE INIC <br />01/02/96 78YiFC0.112 <br />