Laserfiche WebLink
AVCOLOR <br /> Division of R+ M 2 0 21 -0 51 �+Mining and S RECEIVED <br /> Department of Nal D M C/t h m/a wa <br /> 1313 Sherman Stre <br /> Denver,Colorado 5.._,,,, JUL 2 9 20 <br /> CONSTRUCTION MATERIALS WAIN OF RECLAMATiGN <br /> SPECIAL OPERATION 111(1)(b) <br /> IMNIN4 4 SAFETY <br /> RECLAMATION PERMIT APPLICATION FORM <br /> The application for a Construction Materials Special I I I Operation Reclamation Permit contains four major parts: (1) the <br /> application form;(2)Exhibits A-L,Addendum 1,and any sections of Exhibit 6.5 (Geotechnical Stability Exhibit),as required <br /> by the Office,and outlined in Rules 6.1, 6.2, 6.3, 6.5, and 1.6.2(1)(b); (3)the application fee; (4)the Performance Warranty <br /> and Financial Warranty. <br /> When you submit your application,be sure to include one completed,signed and notarized ORIGINAL and one copy of the <br /> completed application form, two copies of Exhibits A-L, Addendum 1, appropriate sections of Exhibit 6.5 (Geotechnical <br /> Stability Exhibit), as required, a check for the S400.00 application fee, and the fully executed Performance Warranty and <br /> Financial Warranty. Exhibits should NOT be bound or in 3-ring binders; maps should be folded to 8 ''/2"X I I"or 8 ''/z"X 14" <br /> 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 clearly,in the space provided,all information described below <br /> 1. Applicant/operator or company name(name to be used on the permit): <br /> �tayY,► �a� j�r�o r'�'�T�, �.C� <br /> 1.1 Type of organization(corporation,partnership,etc.): <br /> 2. Operation name(pit,mine or site name): <br /> 3. Permitted acreage: (must be 30 acres or less) _ Li _Permitted Acres <br /> 4. Fees: <br /> 4.1 New Application 1 ff $400.00 Application Fee <br /> 5. Primary commoditie(s)to be mined: 2nMA kCAr—e, <br /> 6. Name of owner to the surface of affected land: <br /> 7. Name of owner to the subsurface rights of affected land: <br /> 8. Location information: The center of the area where the majority of mining will occur: <br /> COUNTY: M"ro-.'e.' <br /> PRINCIPAL MERIDIAN(check one): F-1 6th(Colorado) 10th(New Mexico) F-1 Utc <br /> SECTION(write number): S <br /> TOWNSHIP(write number and check direction): T 43 _ FN North South <br /> RANGE(write number and check direction): R '3t— East West <br /> QUARTER SECTION(check one): Fj NE F-1 NW F-1 SE F-1_SW <br /> QUARTER/QUARTER SECTION(check one): �_ NE 71 NW F-1 SE F I SW <br /> pF'C'24 <br /> 1313 Sherman Street, Room 215, Denver, CO 80203 P 303.866,3567 F 303.832.8106 http://mining.state.co.us <br /> o <br />