2009-07-13_PERMIT FILE - M2009054 ‎(4)‎

• Permit No: M2009054
• IBM Index Class Name: PERMIT FILE
• Doc Date: 7/13/2009
• Doc Name: New 112c Application
• From: All-Rite Paving & Redi-Mix, Inc.
• To: DRMS
• Media Type: D
• Archive: No

-8-
C:erti.tlcatton:
As an authorized representative of the applicant, Ihereby 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) inexistence 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 applicantloperator, I do not have any extrachonlexploration 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. 1 understand that statements in the application are being made under penalty of perjury said 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 to section 34-32.5-112,GRS., of the Colorado Land
Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this form shall result In voiding any
permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties for operating
without a permit pursuant to section 34-32.5-123, C.R.S.
Signed and dated this day of n' 't, , 2009
All-Rite Paving Redi-Mix, Inc.
Applicant/Operator or ompany e
Title: --C, If Corporation Attest (Seal)
Signed.
Signed:
Car 'rate Secretary or Equivalent
p
Town/City/County Clerk
State of, Colorado
County of
Ili,- foregoing instrument was acknowledged before =this day of-. ._'----- ?_ _ "21[)0
by o. as . ?e? of cli! -..._ ..-.?, /ytc_
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SIGNATURES MUST BY IN BLUE INK