Laserfiche WebLink
-7- <br />Certification: <br />As an authorized representative of the applicant. I hereby certify that the operation described has met the minimum requirements ofthe <br />following terns and conditions- <br />All necessary approvals from local government have been applied for (Section 34-32.5-110(1)(0)(Vlll). <br />2. To the best of my knowledge, all significant.,ireluable and permanent man-made structure(s) in existence-at the time this <br />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.). (NOTE, por 111) operations, the affected area includes all lands delineated by the permit <br />boundary.) <br />No mining.operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4xf), <br />C.R.S.). <br />4. As the applicantl/operator, I do not have any mining/exploration operations in the State of Colorado currently in violation of <br />the provisions ofthe Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34.32.5-120, C.R.S.). <br />5. 1 understand that statements in the application are being tnadc undcr•penalty of penury and that raise statements made herein <br />are punishable as. a Class 1 misdemeanor pursuant to Section 18-8-503, G.R.S. 1984. <br />Tlds fornt has been approved by the Alined Land Reclamation Board prrrsuarrt to section 34-32.5-I.IO,CR.S., of the Colorado Land <br />Reclaruation Actfor the Extraction oJConshrrction rlfaterials Any alteration or nrod y7cation of tldsfortn shall result fit voiding any <br />permit issued on the altered or nrodifred form and subjecrthe operator to cease and desist orders and civil penalties for operating <br />without a perinit pursuant to sectiotr 34-32.5-123, C.R.S. <br />Signed and dated tliis day of <br />Applicant/Operator <br />tf Corporation Attest (Seal) <br />Siyietl. ?? - <br />Title: ?f-t <br />Signed: <br />Corporate Secretary air Equivalent <br />Town/City/County Clerk <br />Statc of ?+' nrt i r?C7 ) <br />ss. <br />County of ?? NIP\ <br />7-he foregoing?i?n?strwinlem was acknowledged before me this day of <br />by ..`?:rn?osLr? as n zr of n.' S' <br />otary Public <br />My Commission expires: 4 <br />?•CIGNATURES MUST BE IN BLUE INK <br />\. ?•••..At'