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-8- <br />('ertification: <br />As an authorized representative ofthe applicant, i hereby certify that the operation described has met the minimum requirements <br />of the fullowinc terms and conditions: <br />1. To the best of my knowledge, all sitTi icant. valuable and permanent man-made structure(s) in existence at the time <br />this application is filed, and located within 206 feet of the proposed affected area have been identified in this application <br />(Section 34-32.5-1 15(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)(1), ('.R.S.: <br />3. As the applicantioperator, i do not have any extract ion'ex1) loration operation, in the State af('olorado currently in <br />violation of the provisions of the Colorado i.and Reclamation Act for the I-Airaction of Construction Materials <br />(Section 34-32.5-120, C.R.S.) as determined through a Board finding. <br />4. 1 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 18-8-563, C.R.S. <br />This form has been approved by the ,{lined Land Reclamation Board pursuant to section 34-32.5-11 2,C.R.S., of they Colorado Land <br />Reclaunation Aet for the Evraction oj'C'o?tstrtt(•tion ,liaterials. , tt* r alteration or modification of this form shall result in voiding any <br />permit issaed on the altered or modified jortn and subject the operator to cease and desist orders anal e•is-il penalties fix operating <br />n4thout a permit pursuant to section 3.1-32.5-123, C.R.S. <br />Signed and dated this Lfb tb day of - ?? h-- ------ - -- __-- • p700 / <br />0/740/L'4.reL if Corporation Attest (Seal) <br />Applicant Operator or Company Name <br />Signed: Signed:.- - <br />Corporate Secretary or Equivalent <br />Title: TowniCity%County Clerk <br />State of aIOraa.0 ) <br />ss. <br />County of } <br />1 he foregoing instrument was acknoA lodged b6-re me th:, 30 day of arCj--? <br />20Cx1 by Al t3okt i Ow Nee- AJ Botts CDngtrudLon ?Gwjel <br />=STATE TEPHENSON orir v 1'tibhc <br />Y PUBLIC <br />COLORADO <br />„\ ('0111rnrss,c,n expires q ? 17- Zol ? <br />SIt:\ \I 1 MIS Sit s'I III. IN III FF INK