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<br />-5- <br /> <br />4. I understand that statements in the application are being made under penalty <br />of per3ury and that false statements made herein are punishable as a Class 1 <br />misdemeanor pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this -r day of &ALA, , 1893 <br />Applicant/Operator <br />8y: 1v L . UU l?l <br />Title: i)A DAJd#M--A O( <br />State of ) <br />,?} ) ss. <br />County of Q N ) <br />If Corporation Attest (Seal) <br />By: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this a 7 day of L9? <br />by as allqt."QA AW 4 ofQ h f,?1?c;;• ?Y`. <br />4-; -- Notary Public <br />& = Y <br />My Commission Expires: S <br />2823F (02105193) <br />Hearing on Permit No. M-1987-038 <br />Bayfield Pit No. 1 <br />SUIT00005