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=~- <br />Certificatioa: <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. 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.). <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 applicantloperator, 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 />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 18-6-503, C.R.S. <br />Signed and dated this ~ day of OGr~~£/r ~/7 <br />~irrA~R Co~s-ri?u~-~o~ Gv/r1,oA/Uy <br />Applicant/Operator or Company N/ame <br />Signed: ~ ~~~r1 <br />Title: /"/~.ES/4E/1JT <br />If Corporation Attest (Seal) <br />Signed: ~ r.~-r ~ r~~%~~,~> i~ 7: -f'., <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />Slate of (~fl~V/GA'~V ) <br />County of ) <br />Thecfooreng)oing insjt~r{ument was acknowlendged before me thisQ2~ day of ~ci-~~~r j~, <br />by k/~A'" k' ~~ V~AL9 as ~/C~~~~N7 of ,~~rA~~4 Ca/~ST/lt~~roXJ~'p. <br />y <br />GrL~1.~n ~~~. <br />Notary Public Q <br />My Commission expires: ~ -~[J- 9 / <br />SIGNATIIRES MIIST 8H IN HLIIE INK <br />06/26/97 2823FCO.112 V; •, <br />?• TERRI <br />BASHTON <br />