Laserfiche WebLink
• <br />Certification: <br />-7- <br />As an authorized representative ofthe applicant, l hereby certify that the operation described has niet the minimum requia•ernents of the <br />following terms and conditions: <br />All necessary approvals from local Povernment have been applied Ibr (Section 34-32.5-110(1)(a)(Vll.l). <br />2. '1'o the best of my knowledge, all significant, valuable anal. permanent man-made structure(s) in existence at the time this <br />application is filed, and located within 200 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-115(4)(e), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit <br />boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32,5-115(4)(1) <br />C. R.S. ). <br />4. As the applicandoperator, I do not have any mining/exploration operations in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.), <br />5. I understand that statements in the application are being made under penalty of perjury and that .false statements made herein, <br />are punishable as a Class I misdemeanor pursuant to Section 1.5-8-503, C.R.S. 1984. <br />Thin form has been approved by flit il:titced Land Reclantatiou BoaMpursuaw to section 34-32.5-110,C.R.S., ofthe Colorado hettul <br />Reclamation Act for tlce Extraction i /f C'onstritetioit ,Vaterials. Any alteration or modification of this form shall result in voiding <br />arty pet•nde issued on the altered or modified forth and subject the operator to cease and desist orders and civil penalties for <br />operating without a permit pursuant to section 34-32.5-123, C.R.S. <br />Signed and elated this day of <br />G ApphYalt'Opt;r for <br />Signe @ - <br />Title: <br />Slateol Q <br />Co. ]no'({'C <br />If Corporation Attest (Seal) <br />Si nee x J??.?? ? ?- i <br />Corporate Secretary 4-i; - Equivalent <br />Town City,Cuunty Clerk L <br />} - t.7 '<?rritY'}, .17: tl. .F*t.?.#it v? .> I.:. ,.r).sLY ll;,i?-?.,vtCli-e in( .his <br />1 fl.alr of <br />e... <br />r>v . ??alo..._Rn?n:? _lR_- Se.rect-??1.. 1r-! t:._y.t'Ylar>?.n_ <br />Notary Public <br />Nly Commission expires: <br />Xh p1AR <br />Sl(3.N"A'tt RFS MUST B llV lll..t E I4I.C ??rs'?,Q?(^4