Laserfiche WebLink
Certification: Division of Reclamation, <br />Mining & Safety <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum <br />requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man -made structure(s) in existence at the time <br />this 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)(e), C.R.S.). <br />2. 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.; <br />3. As the applicant/operator, I do not have any extraction/exploration operations in the 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.) as determined through a Board finding. <br />4. 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. <br />This form has been approved by the Mined Land Reclamation Board pursuant to section 34- 32.5- 112,C.R.S., of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this fora: shall result in voiding any <br />permit issued on the altered or modified fora: 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 />Signed and dated this Jo? l ` day of r�T1z L , ca)Q L., <br />is°'� If i. Attest (Seal) <br />Signed: ( ; ;It h e ."�� ,�;; , ++ orate ' retary or Equivalent <br />Title: 0 )tavc. 1 S _. _L.ett / 2J1c t_ed-o - ? -' 2 #. Town/City /County Clerk <br />� :'d <br />City of Greeley <br />Applicant/Operator or Company Name <br />State of CL.Oter <br />County j -e_1 ss. <br />Coun of t ) <br />- 8 - <br />Not a <br />SIGNATURES MUST BE IN BLUE INK <br />FCCUMIVLIJ <br />APR 192012 <br />a/OA:Li <br />The foregoing 'nstrument was acknowledged before me this id day of <br />&o / by as 6 )011.0a .4J of G <br />iQ �2Q1 <br />� '` <br />My Commission expires: 1 - 3/ ��,� <br />You must post sufficient Notices at the location of the proposed mine site to clearly identify the site as the location of a <br />