2010-12-14_PERMIT FILE - M2010071

• Permit No: M2010071
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/14/2010
• Doc Name: Registered w/ Boulder County Clerk & recorder
• From: City of Lafayette
• To: DRMS
• Email Name: MAC
• Media Type: D
• Archive: No

ul er County Clerk Recorder
Certification:
RECE1VP-n
-8- DEC 14 2010
Division o, r. maven,
Oning and Safety
DEC 14.2010
As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum
requirements of the following terms and conditions:
1. To the best ofmy 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 3432:5-115(4)(f), C.R:S.;
3. As the applicant/operator, I do not have any extraction/exploration 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 and 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 apprm ed by the Mined Land Reclamation Boardpursuant to section 3¢32.5-I12,CR;S., of the Colorado land
Reclamation Act for the Ex7raction of Construction Materials Any alteration or modification of this form; shall result in roidirig any
permit issued ion the altered or modified form and subject tile operator to cease and desist orders and civil penalties for operating
without a permit pursuant to section 34-325-123, C R.S.
Signed and dated this . Fr-' h day of l) G) c"L V <2-)/ 0
Goose Haven Reservoir #2 - Complex Expans' LfCol
Applicantloperator or Company Name
11?R s • i ° ???
w
(\J///' S8
Signed: RILE
Title: t.. `_
btig RIB.
Age °`°•??
/n? Ap Y l s.
State of l?? C'f?.? } !?('?\\\N+Nv
)Ss.
County of _2nA&n, }
The foregoing instrument was acknowledged before me this I -3? day of
0 ,by &-Cn, ?S ?G??nCke_ as ?h n-i r ts?rz. of .?, .. ok Lc_...
`• ? •'4!i'F Notary Public
r My Commission expires: liJ 1 t i.
Attest (Seal)
Corporate Secretary or Equivalent
Town/City/County Clerk.
ANA TURE$ B>i? IN BLUE INK
?`?,t?
You must post sufficient Notices at the afifl osed mine site to clearly identify the site as the location of a