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epa OF COLOI�A 0 <br /> DIVISION OF RECLAMATION,Ml, M-20i B-057 D <br /> Drtmt,ntof Natural Resources RECEIVE <br /> 1313 Sherman 5t.,Room 215 <br /> Denver,Colorado 80203 JLE/mac r'o,8 IRECLAMATION <br /> O R A D <br /> Phone:t303)866.3567 OCT 29 L DIVISION OF <br /> FAX:i303)832-8106 INING <br /> DIVISION OF RECLAMATION SAFETY <br /> DESIGNATED MINING MINING AND SAFETY <br /> LIMITED IMPACT(i 1041)OPERATION <br /> RECLAMATION PERMIT APPLICATION FORM <br /> CJJECK ONW: New Application(crux t,a) DAmendment Application(Rule I_aor 1.10) <br /> Conversion Application(Rule I.11) <br /> Permit 4 M- - (provide for Amendments and Conversions of existing permits) <br /> The application for a Limited impact(I 10d)Designated Mining Operation Reclamation Permit contains three major parts; (1)the application <br /> fomt;(2)Exhibits A-J,Exhibit L,Exhibit T,the Gcotechnical Stability Exhibit,the Emergency Response Plan,and Addendum 1,as required by <br /> the Office,and outlined in Rules 6.1,6.2,6.3,6.4.20 6.5.8,and L6.2(1 Nb};and(3)the application fee.When you submit your application,be sure <br /> to include one(1)signed and notarized Orminal and one(1)copy ofthe application form.two(2)copies of Exhibits A-J,Exhibit L,Exhibit T,Elie <br /> Gcowchmcal Stability Exhibit(Rule 6.5),the Emergency Response Plan(Rule 8).and Addendum 1(Rule 1.6.2(1)(bj).as required.and a check for <br /> the application fee described under(4)below. Exhibits should NOT be bound or in 3-ring binders;maps should be folded to 8 2^X i i"or 8 2"X <br /> 14"size. To expedite processing,please provide the information in the format and order described in this form- <br /> GENERAL OPERATION INFORMATION <br /> Type or print gleamy,in the space provided,all information described below. <br /> i. AMlemWonerator or comp navname(name to be used on permit): Venture Resources, Inc. <br /> 1.1 Type of organization(corporation,partnership.etc.)' Corporation <br /> 1.2 I.R.S.Tax 1D No.or Social Security!dumber: <br /> Operation name(nit,mine or site name): Old Town Reclamation Project <br /> 3. Permitted acreage(neN or existing site): pctmitted acres <br /> 3.1 Change in acreage(-) acres <br /> Total Acreage in Permit Area 2.76 acres <br /> 4. Fees. (Rule 1.5) <br /> 4.1 New Application 52AN.00 application fee <br /> 4.2 Amendment Fee(operations existing as of 0660194) $1,725.00 application fee <br /> 4.3 Amendment Fee(operations permitted from 07101r94) $3,300.00 application fee <br /> 4A After July 1.1995,to convert a 1 10(1),110(2)or a 110 to a 110(d),a new application form fora 1 l0d must be submitted.along <br /> with an application fee of$2.875.00(Rule 1.11.2(2)). <br /> 5_ Prirnary commodities to he mined.6. "i'vpe of mining operation: Surface 0 Underground F In-situ <br /> Office of _. Office of <br /> Mined Ldnd Reclamation L)enver - Grand)unction - Durango Active and Inactive Mines <br /> 3 <br />