Laserfiche WebLink
DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St . Room 215 <br />Denver Colorado 80203 <br />Phone (303)866-3562 <br />FAX 4303)832-8106 <br />STATE OF COLORADO <br />CONSTRUCTION MATERIALS <br />LIMITED IMPACT (110) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />COLORADO <br />ors i,ion of <br />RECLAMATION <br />MINING <br />SAFETY <br />S HECK ON(i. _0 There k a File Number Already Assigned to this Operation <br />Permit , _M - — 1 Please reference the life number currently assigned to this operation 1 <br />H:=1 sire Application (Rule IA 5) Amendment Appbcaton (Rule 110) <br />Conversion Application (Rule 1 11 r <br />Pet nit .5 M->iCli' -C11 - (punidc Mr Amendments and Conversions of exrsnng pentium) <br />The application fora Construction Matenals Linuted Impact (1101 Operation Reclamation Penne contains three major parts t t the <br />application form. (21 Exhibits A -J. Exhibit l Addendum 1, any sections of Exhibit 6 5 and (Twit -choice! Stability Exhibit as required by <br />the Oflice and outlined in Rules M1.1,6 2, 6.3, 6, s, aid 16 2(1 fib). and (3, the application fee. When you submit your app luauun. be sure <br />to include one 11 I gumalete signed aj nutariz d ORIGLNAI, and one 111 copy of the completed application form. txvo (2) copies of <br />Exhibits A -l. Exhibit L. Addendum 1. and apprupnate sections of 6 5 IGeotechntcal Stability Exhibit). an required, and a check for the <br />application fee descnbed under t41 below Exhibits should HQi be bound or in a 3 -ring binder, amps should be folded to It 12" X 1 1"or % <br />1 2" XIS' site To expedite processing, please provide the information a1 the format and order des nbcd in this form <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information described beton. <br />I AnpRcanvoperator or COMpanv RAMC (name to be used on oennitl K V Y1. ( Q.4 to Al <br />it 1 ypc of organisation 1 corporation, pannershtp, cu 1 L (. L <br />Ooerntion mune (oil. mine or site mussel ((,, j Ft!. (II (' 1 Luau) `3 i -r, t It LL. ✓ l <br />3 Permitted acreage leen or existing site( permitted acres <br />3 I Change to acreage 1-1 ora <br />3 2 Total Acreage in Pemut Arca ', S acres <br />4 frit <br />4,1 Ncu Application <br />Amendment Fee (C 11,S 34-32 5-125(1(11' <br />5125$00 application fcc <br />502'1 00 application tee <br />5 primer von to be mined. k�C i4 ;w °kn J / <br />5 1 Incidental commodaieis) to be mined I i Clbs Tons vo 2 lbs Tons vt 3 <br />4 lbs Tons 5 r 5 lbs -roar sq <br />5 2 Anticipated end use of pnmarc commodiue(s) to be mined' a L' q / <br />Ibs Toru yr <br />Anticipated end use of incidental connnodtnes'1 to be mined _ 3'L' C/% <br />