2007-12-14_PERMIT FILE - M2007087 ‎(2)‎

• Permit No: M2007087
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/14/2007
• Doc Name: New Appl
• From: Albert Frei and Sons, Inc.
• To: DRMS
• Media Type: D
• Archive: No

-8-
Certification:
As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of
the following terms and conditions:
1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this
application is filed, and located within 200 feet of the proposed affected area have been identified in this application
(Section 34-32.5-115(4)(e), C.R.S.).
2. No mining operation will be located on lands where such operations are prohibited by law
(Section 34-32.5-115(4)(f), C.R.S.;
3. As the applicanUoperator, I do not have any extraction/exploration operations in the State of Colorado currently in
violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials
(Section 34-32.5-120, C.R.S.) as determined through a Board finding.
4. I understand that statements in the application are being made under penalty of perjury and that false statements made
herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S.
This form has been approved by the Mined Land Reclamation Board pursuant tv section 34-32.5-112,C.RS., of the Colorado Land
Reclamation Aci for the F-xrradion of Construction Materials. Any alteration or modification of this form shall result in voiding any
permit issued on the altered or modified form a»d subject the operator to cease and desist orders and civil penalties for operating »~dJiout
a permit pursuant to section .~4--32.5-123, C.RS,,
Signed and dated this a' ~ day of ~ (~ \/ ~ /~ ~ ~~ ~ 2- ©©
_Albert Frei and Sons, Inc.
ApplicanUOperator or Compairy ame
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Signed:
Title: President
If Corporation Attest (Seal)
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Slgned: ~ -
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Corporate Secr~tati-y:or Equivalent -~ s~
Town/City/CountyEl€rk ; %? ' ~~ ^
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State of Colorado ~
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County of Adams )
The foregoing instrument was acknowledged before me this _ ~}~ day of ~V2nn_~,.v~-
by Albert R. Frei. Jr. as President ,~, of Albert Frei and Sons, Inc.
((""~~~~7 qy ~ f~:~i.2 ~f"4. LJ 0..w,
R+r $ 5
ITV (~~~ ~ie~~,±35~51 ~ °St~a;..~' `~ r`1i~y~ja,,,n~"~
My Commission expires: ~o`.~~ o2-Q~g
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SIGNATURES MUST BE IN BLUE INK