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2011-12-21_PERMIT FILE - M2011033 (2)
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2011-12-21_PERMIT FILE - M2011033 (2)
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Last modified
8/24/2016 4:46:23 PM
Creation date
12/28/2011 7:24:06 AM
Metadata
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Template:
DRMS Permit Index
Permit No
M2011033
IBM Index Class Name
PERMIT FILE
Doc Date
12/21/2011
Doc Name
Complete copy of approved 110c- RECLAMATION ONLY application package
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DRMS
To
DRMS
Email Name
PSH
Media Type
D
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Certification: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the <br />following terms and conditions: <br />1. All necessary approvals from local government have been applied for (Section 34- 32.5- 110(1)(a)(VIII). <br />2. To the best of my knowledge, all significant, valuable 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(4Xe), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit <br />boundary.) <br />3. 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 applicant/operator, I do not have any mining/exploration operations in the State of Colorado currently in violation of <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34 32.5 - 120, C.R.S.). <br />5. I understand that statements in the application are being made under penalty of perjury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18 - 8 - 503, C.R.S. 1984. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34- 32.5- 110,CRS, of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials. Any alteration or modification ofthisform shall result in voiding any <br />permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties for operating <br />without a permit pursuant to section 34- 32.5 -123, C.R.S. <br />(2q 'k''- day of AZ -I--- , 2011 <br />Signed and dated this <br />Harry Corkle Const <br />Applicant/Operator <br />Signed: <br />r 7 <br />Title: President <br />State of Colorado ) <br />) ss. <br />County of <br />Jackson <br />The foregoing instrument was acknowledged before me this <br />b Harry Corkle as President <br />- 7 - <br />s DEBRA L. GREENE <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />My Commission Expires 06 /23 /2 MNATURES MUST BE IN BLUE INK <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />day of A U9us+ <br />of Harry Corkle Const <br />Notary Public <br />My Commission expires: (o /pd 3/ 2 0 ) o.. <br />
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