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<br />' Certificatioa: <br />Title: /v/Tn~f}~c Fi~, <br />- 6 - <br />' As an authorized 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. All necessary approvals from local government have been applied for <br />(Section 34-32.5-110(1)(a)(viii). <br />2. 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(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands <br />delineated by the permit boundary.) <br />' 3. 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 />4. As the applicant/operator, I do not have any mining/prospecting 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, <br />C.R.S.). <br />' S. 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-B-503, C.R.S 1984. <br />' Signed and dated this J ~ day of ~~//fi /9qS <br />~t_-~ <br />If Corporation Attest (Seal) <br />' ppllcan[/ erator~ I ~/s1L ~ ~ /! <br />Signed: ~©GK ~SL/WD ~~~ C;O ~-[..c~,Signed: <br />I <br />I <br />I <br />I <br />I <br />i~ <br /> <br />State of 0 ) <br />ss <br />County of ~m~f ) <br />The Qqforegoing instrume was acknowledged before me <br />by_.~llfl7 ~Itl < III as f ' <br />h.....w. .~. .. <br />LAURA RUSSETTE '~ - <br />NOTARY PUBLIC ~" <br />STATE OF COLORADO ~~ My <br />!. <br />~ My Commission Expires 03132000 ~"' <br /> <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />this//r/~day f ~i[C~ ~~, <br />o f C h C' <br />N~tary Public <br />Co i sion expires: <br />SIGNATQBYSdM[TST BE IN BLIIE INtC <br />04/25/97 2621FC0. 110 <br />i~ <br />