Laserfiche WebLink
STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 COLORADO <br /> Denver,Colorado 80203 D I V I S I O N O F <br /> Phone:(303)866-3567 RECLAMATION <br /> FAX:(303)832-8106 MINING <br /> SAFETY <br /> LIMITED IMPACT OPERATION(110(2)) <br /> RECLAMATION PERMIT <br /> APPLICATION FORM <br /> CHECK ONE: ►s New Application(Rule 1.4) n Conversion Application(Rule 1.11) <br /> Permit#M- - (provide for conversions of existing permits) <br /> The application for a Limited impact Designated Mining Operation Reclamation Permit contains three major parts: (1)the application <br /> form; (2) Exhibits A-I, any required sections of Exhibit S and Geotechnical Stability Exhibit, as required by the Office,and outlined in <br /> Rules 6.1,6.2,6.3, 6.4.19 and 6.5; and(3)the application fee. When you submit your application,be sure to include one(1)signed and <br /> notarized original and one(1)copy of the application form,two(2)copies of Exhibits A-3,appropriate sections of 6.4.19 Exhibit S and 6.5 <br /> (Geotechnical Stability Exhibit),as required,and a check for the application fee described under(4)below. Exhibits should not be bound <br /> or in a 3-ring binder;maps should be folded to 8 1/2"X 11"or 8 1/2"X 14"size. To expedite processing,please provide the information <br /> in the format and order described in this form. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly,in the space provided,all information described below <br /> 1. Applicant/operator or company name(name to be used on the permit):CO t o(0-A.0 H i n■1k - ELF 1 oroz ie%r\- <br /> 1.1 Type of organization(corporation,partnership,etc.): 1-LC_ <br /> 2. Operation name(pit,mine or site name): C('' F-A—a.\ ` <br /> 3. Permitted acreage(new or existing site): ( B permitted acres <br /> 4. Fees: <br /> 4.1 New Application 51,006.00 application fee <br /> 4.2 Amendment Application(from 1.10(2)) <br /> 4.3 Conversion Fee(from 110d to 110(2),(Rule 1.11.2(2)) $1.725.00 conversion fee <br /> 5. Primary commodities)to be mined: n is i J iVe-(` f t I ^ <br /> 6. Name of owner to the surface of affected land: ' i 1 i/&—d 4T` `` V`n∎(t CV. <br /> 7. Name of owner to the subsurface rights of affected land: J c\V— 1 1\ 11;/);A/ Co <br /> 8. Type of mining operation: ® Surface u Underground LI In-situ <br /> Office of Office of <br /> Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />