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-s- <br />Certification: <br />As an authorized representative of the applicant, 1 hereby certify that the operation described has ntct till, mininnun <br />requirements of the following terms and conditions: <br />1. To the best of my knowledge., all significant, valuable and permanent man-made strucarre(s) in existence at the time <br />this application is filed, and located within 200 feet ofthe.proposecl affected area have been identified in this application <br />(Section 34-32.5-115(4)(c), C,R.S.). <br />2. No training 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 applic:mtioperator, I do not have any extnctionlexploration olierations 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 />(Sccloc?n 34-32.5-120,,C.R.S.) as clestcmlinedthrou3h,a Board_fincting, - <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 18-5-503, C.R.S. <br />Thus form has been approver/ by the Alined Lane/ Reclamation Board pursuant ter section 34-32.5-113,0 R S., of the Colorado) Laced <br />Rechanudom.-tct frrr the E traction ref Constructien AJateria s. At!r aheraliorr or nrudificaliort of dris finrn+ shall resn!! hta ?witlir{t,? any <br />permit issuer/ an the altered or nrodifned faro and subject the operator to cease and desist orders. and -civil penrrrldes fEnr dperatinl; <br />without a permit pursuant In section 34-32.5-123. C. R..S. 'e6t s45 S '°?Y?Qt1CB. <br />SiDmed and dated this day of FEBRUARY <br />LEONE SAND & GRAVEL LLC f <br />Applicant,'Operatir or Company Namc <br />Sighed: ?Z? <br />FRANK LEONE JR.' <br />Title: MANAGER <br />State of COLORADO <br />) ss. <br />County of LAS ANIMAS <br />Signed: °w( s?trr?.,, <br />Corporate Secretary or Equivalent <br />I'own/ciry;'Gtunty Clerk <br />The foregoing instrument was ackrim-dedged before me this GjI*- clay of FEBRUARY <br />2010, by FRANK LEONE JR. as MAN.A.GEER? of LEONE SAND & GRAVEL LLC <br />Notary Public <br />t\•1y Commission expires: 01 / 06 / 2014 <br />SIGNATURES MUST RE IN BLUE INK <br />You roust post sufficient Notices at the location of the proposed mine site to clearly identify the site as the location of a