Laserfiche WebLink
Gv/rls ~o ~i7')G <br />-~- <br />Certification: <br />//Yl-~aoa - ce 9 y. <br />/hc4sFerr~ l'!'lol7~(e~~~~~~~,r~T~ <br />~ ~"~" p` ~~~ FEB 2 0 2002 <br />A~piiC(~ron <br />fJirision of ABioerals and Geology <br />As an authorized representative of the applicant, I hereby certify that the operafion 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 Gore <br />this application is filed, and located within 200 feet of the proposed affected azea have been identified in this application <br />(Section 34-32.5-115(4)(e), C.R.S J. <br />2. No mining operafion will be located on lands where such operations are prohibited bylaw (Section <br />34-32.5-115(4)(f), C.R.S.; <br />3. As the applicanUoperator, I do not have any extracflon/exploration operafions in the State of Colorado currently in <br />violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Secfion <br />34-32.5-120, C.R.S.) as determined through a Board fording. <br />4. I understand that statements in the application are being made under penalty of perjury and that false statements <br />made herein aze punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. a,~+~' :'hl•l. ~, <br />,,~f~ - 'L <br />Signed and dated this ~ S ~ day of ~ B ~ uR ~ 2C~ Z ~` '' ^'~'`0, :,,, ~~~ <br />I/~/[?S~tertS A.lab'1le Soi,~-N,em1S~c. <br />ApplicanUOperator or Company Name <br />Signed: <br />Ti[Le: ~ rt:~ 1~ P~tJA~i=.~ <br />Stale of t%B~~ ) <br />County of ,C~iC~ ~~--~ j ss <br />Town/City/County Clerk <br />The foregggoin~~g insttrument was acknowledged before me this l ~~~ day of _ 2° ~u-c v{OG 2, <br />by UGC. ~J~ as i~~iXafPJ~ of ~~~1-_-~.~i'u.~z/,K~C <br />,_. <br />MARGARET F. CASTLEBERRY ~///Gb1~9/~ ~ C 24:~Z21.~-~-~'/~ <br />Notary Public ' <br />State of Colorado Notary is <br />My Commission expires: 9 ~-~/~ <br />SIGNATURES MUST BE IN BLUE INK <br />If Corporation Attest (Seal)s.'' ;? '~;~ T-, <br />.,.;.1.Ir.. <br />+:: <br />/ ~ <br />Signed: V , <br />~~. Corporate Secretary or Equivalent <br />M:4MVi1HDCaMINFORMS12823C012.APP 10/ll/01 <br />