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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 <br />requirements 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 applicant/operator, I donot have any extraction/exploration operations in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials <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 statements <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,CR.S., of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this form shall result in voiding any <br />permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties for operating <br />without a permit pursuant to section 34-32.5-123, C.R.S. <br />Signed and dated this ~i day of C~U nP_ a +~~ <br />pN EkC <br />rl°CISl0Y1 ~XCAy0~~1 Y\A. TY1C. (~~;GpRPppgLy~' <br />Applicant/O erator or Company ame ~ : `9~ ~ Z <br />a' S'~ m~c <br />Signed: ~'' v Z/` •.~ ; •:n <br />•.~RAD~. <br />•....... <br />Title: President <br />State of Colorado _) <br />.~ ) ss. <br />County of ~O [ t.1 <br />Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />The foregoTing instrument was acknowledged before me this ~~ day of ~UY1C- <br />,by ~JUVid S . ZehnEf as pres ~ cl~,-,fi of Pr~c'~sior, ~xc.avatina.Inr~. <br />:' '•G '~' <br />,Q ~r otary Public <br />• ~ .~ <br />y~% ; (7 (~ <br />~: F y Commission expires: ~ o~-~ ~ `V`7 <br />~'• ••• <br />••...... <br />SIGNATURES LUE INK <br />You must post sufficient Notices at the location of the proposed mine site to clearly identify the site as the location of a <br />