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-8- <br />Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements <br />of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time <br />this 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.). <br />2. No mining operation will be located on lands where such operations are prohibited by law <br />(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 State of Colorado currentlyin,: <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction-. Ma#erials <br />(Section 34-32.5-120, C.R.S.) as determined through a Board finding. <br />4. I understand that statements in the application are being made under penalty of perjury and that;false stiifeixtent <br />made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32.5-112,C.R.S:, offhiloip <br />Reclamation Ad for the Extraction of Construction Materials. Any alteration or modifTeation of this form shall resr?l[ v6Yd{/ <br />permit issued on the altered or modifeed form and subject the operator to cease and desist orders and civil penatt,/8i o?ie <br />without a permit pursuant to section 34-32.5-123, C.R.S. <br />Signed and dated this day of <br />READY MIXED CONCRETE COMPANY dba <br />READY MIXED AGGREGATES, INC. <br />[f Corporation Attest (Seal] <br />ApplicantlOperator r Company Name <br />Signed: <br />Title: General Manager <br />State ()f _C o l o r a d o <br />j ss. <br />Count)rof Denv_er_? <br /> <br />4 <br />Y ed <br />H,'C t <br />t'yjn ? - 6C?a <br />, 13 <br />J WSL f"1?i. <br />Corporate Secretary or Equtval8ttt <br />Town/City/Count,Clerk <br />r-k C a 9 <br />The faregoing instrument %vas acknowledged before me this. ._ ?clay. of /'n air ?__? . _z <br />LU, 7i m rri o rl S /? <br />by as ._6 6 n .era / /"a n a e i' of _1c,2eacCy 4, <br />.... Y_...... _.._._._ <br />...__._..._..... ...... . .......... .... __.....................- ....... <br />ca"I C, e- <br />- P <br />MARY <br />YOUNG :rte <br />OF CO?-? <br />Notary Public <br />My Commission expires: -7Z <br />TURES MUST BE IN BLUE INK