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-6- <br />Certification <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of <br />the following terms and conditions: <br />1. All necessary approvals from local government have been applied for (Section 34-32.5-111(1)(a)(IX)); <br />2. This entire mining operation will not affect more than 30 acres; <br />3. This mining operation will not adversely affect the stability of any significant, valuable and permanent man-made <br />structure(s) located within two hundred (200) feet of the affected lands. (However, where there is an agreement between <br />the applicant/operator and the persons having an interest in the structure that damage to the structure is to be compensated <br />for by the applicant/operator (Section 34-32.5-115(4)(e), C.R.S. 1984, as amended), then mining may occur within 200 feet. <br />Proof of an agreement must be submitted to the Office prior to the decision date.) <br />4. 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. 1984, as amended); <br />5. As the applicant/operator, I do not have any mining/exploration operations in this 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. 1984, as amended) as determined through a Board finding. <br />6. 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. 1984, as amended. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32.5-111,CR.S., of tine Colorado <br />Land Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this form shall result in <br />voiding any permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties <br />for operating without a permit pursuant to section 34-32.5-123, C.R.S. <br />Signed and dated this 15 day of 7u y , 2 n 1 n <br />Castle Rock Construction Company of Colorado, If Corporation Attest (Seal) <br />Applicant/Operator LLC <br />By: By: <br />Title: Ralph Bell, COO <br />State of Cnloradn ) <br />ss. <br />County Of Arapahoe ) <br />The foregoing instrument was acknowledged before me this 15 day of Jul <br />by Ralph Bell as c'nn of Castle Rock <br />Construction <br />Company of <br />201 <br />Col rado, LLC <br />..°? Notary Public <br />q t x p s <br />My Commission expires: 5 -Z Z- Z ?l Z <br />~SIG1SAgI URES MUST BE IN BLUE INK <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk