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&X141-?r1- M- CS ) <br />Water Quality Control Division - Stormwater www.coloradowaterpermits.com <br />ii. Signature of Permit Legal Contact <br />The application must be signed to be considered complete. In all cases, it shall be signed as follows: <br />a. In the case of corporations, by a responsible corporate officer. The responsible corporate officer is responsible for <br />the overall operation of the facility from which the discharge described in the form originates; <br />b. In the case of partnership, by a general partner; <br />c. In the case of a sole proprietorship, by the proprietor; <br />d. In the case of a municipal, state, or other public facility, by either a principal executive officer or ranking elected <br />official. For purposes of this section, a principal executive officer has responsibility for the overall operation of the <br />facility from which the discharge originates. <br />"I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with <br />a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the <br />person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted <br />is to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant penalties for submitting false <br />information, including the possibility of fine and iMrisonment for knowing violations." <br />05/31/11 <br />Applicant Signature (submission mist include'original ink signature) Date Signed <br />MARTIN R BAUER GENERAL PARTNER <br />Name (printed <br />Title <br />DO NOT INCLUDE PAYMENT-AN INVOICE WILL BE SENT AFTER THE PERMIT CERTIFICATION IS ISSUED. <br />Page 5 of 8 LY <br />Revised 3/2011