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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 teens and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) inexistence 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)(c), 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), C.R.S.; <br />3. As the appllcanUoperator, l do not 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. 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 I tnisdemcanor pursuant to Section 18-8-503, C.R.S. <br />This farm has been approved by the Mined Land Reclamation Boardpurvuant to section 34-3Z5-112,C:R. 9, of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of thin form shall result in voiding any <br />permit issued on the altered or modified fr?rm and subject the operator m 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. 19+?\ day of JUNE <br />2010 <br />NOLAND, INC. <br />if Corporation Attest (Seal) <br />Applicant/Operator or Company Name <br />Signed: pyf.. , L + ? <br />Signed: 1' - - <br />Corporate Secretary or Equivalent <br />Title: President <br />State of Colorado ) <br />) ss. <br />County of Montezuma i <br />Town/City/County Clerk <br />The foregoing instrument was acknowledged before me this "day of JUNE <br />2010. by Ricky F. Noland as President of NOLAND, INC. <br />-?T <br />Notary Public <br />oo**" l*ooo**o*oO&O*0000*00*000 6 My Commission expires:. 05 OCT 2012 <br />NAlNAN A BARYON R <br />NOTARYPUBLIC g SIGNATURES MUST BE IN BLUE INK <br />11,:)2jnt ,CjV, t?A,q 4it %AceP3*hc location of the proposed mine site to clearly identify the site as the location of a