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<br />-~- <br />Certification: <br />JAN 21 2003 <br />Division of Minerals and Gsale~y <br />As an authorized representative of the applicant,l hereby certif}, that the operation described has met the minimum <br />requirements of the following temvs and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this application is filed, and located within 200 feet of the proposed affected azea have been identified in this application <br />(Section 34-32.5-115(4)(e), C.R.S.). <br />2. No coining operation will be located on lands where such operations are prohibited bylaw' (S~~On <br />34-32.5-115(4}(fj, C.R.S.; <br />3. As the applicant/operator, I do not have any exrtraction/exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section <br />34-32.5-120, C.RS J as detemilned through a Boazd finding. <br />4. I understand that statements in the application are being made under penalt}° of perjury and that false statements <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.RS. <br />Signed and datedthis ~~~ day of ~,) /~/(//il%/~2 % , ~O~ <br />Applicant/Operator or Company Name /~ <br /> <br />If CorporationAttesf(Seai _ ,~-F ~ ' <br />/, J <br />f <br />/~. _ r <br />TownlCity/County Clerk <br /> <br />Notary Public <br />at/BL~G:Pa q ~ v5 <br />~p cO~OP My Commission expires: <br />.. _ ~ ~. <br />SIG)I'.Y~iAI.-LiE INK <br />asvrm~r~snan~maeoxnss~zezscrois.nrr oan9rzooz <br />State of Vu~~Ylz~i~ ) <br />II''aa,n,~~ )ss <br />Courtyof 1J~1'C~i~ ) <br />The f-ore~oing instrument was aclmowledged be/f~ore me this ~_ day of r4 Q ~d~~l ~ , ~, <br />by ~I(Y'n ~~=aYlard as f'tGGY? GG1-~ c~1d, VY)Y1Q1', of ~U~G~~0.~ <br />