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COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> Department of Natural Resources <br /> 1313 Sherman Street, Room 215 <br /> Denver,CO 80203 <br /> Date: <br /> RE. Need for State Reclamation Permit: "Is It Mining?" <br /> Name: <br /> Mailing Address: City: State: Zip Code: <br /> Telephone: Cell: (� - <br /> Email: <br /> Enclosed are pertinent sections of the Colorado Mined Land Reclamation Board(Board)Rules governing <br /> activities that do not require a reclamation permit. To determine if you need a permit for you proposed <br /> activity, first check Rule 1.2 which describes activities the Board has determined do not require state <br /> reclamation permits. If you find a match, you can proceed based on your interpretation of the rule, but at <br /> your own risk. If you are uncertain how the Rule may apply to your activity,you should answer the list of <br /> questions below with as much detail as possible. Please feel free to use additional paper, maps, and <br /> attachments to explain your project. <br /> Please include in your determination request answers to the following questions: <br /> 1. Please provide the legal location of the proposed project and submit a site map that clearly <br /> delineates the location of the proposed extraction site and the location of the nearest city,town, <br /> and county location name. <br /> Section ;Township ;Range ;PM County <br /> Or NAD27 GPS X UTM Y UTM <br /> Direction and miles to nearest town/city <br /> 2. Is the site of material extraction on public or privately owned property? <br /> 3. What type(s)of material or metal is/are proposed to be extracted and describe the physical nature <br /> of the site i.e.,river terrace,rocky knob, in-stream gravel deposit,etc.? <br /> 4. What processing or extraction method(s)will be used on site?Include any equipment or <br /> chemicals)that will be used in the processing and extraction of the materials. <br /> 5. Will the extracted material be hauled offsite or used on the same parcel of property where the <br /> material is extracted? <br /> 6. How will the extracted material be used on site? <br /> 7. If the material is hauled offsite,where will it be hauled to and what it the intended use? <br /> co <br /> 1313 Sherman Street, Room 215,Denver,CO 80203 P 303.866.3567 F 303.832.8106 http://mining.state.co.us <br /> 4, <br /> John W.Hickenlooper,Governor I Mike King,Executive Director I Virginia Brannon,Director - . <br /> _?876/' <br />