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a�eon <br /> COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> +s,6� 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br /> APPLICATION FORM FOR A PERMIT <br /> TO <br /> CONDUCT COAL MINING IN COLORADO <br /> Application to conduct surface or underground coal mining activities or other surface coal mining and <br /> reclamation operations in Colorado pursuant to C.R.S. 34-33-101 et seq. <br /> For an application to be deemed complete by the Division pursuant to C.R.S. 34-33-103(5) and Rule <br /> 1.04(30), an applicant must: (1) supply all information as specified on this application form; (2) submit <br /> five reproducible copies of the permit application with original signatures; and (3) pay the appropriate fee <br /> required by Rule 2.01.6. For federal mines, please refer to the Federal Agency Mailing List available <br /> from the Division and provide one copy to each of the agencies on that list, at the same time the <br /> application is submitted to the Division. Proof of distribution to the federal agencies should accompany <br /> the application. Copies of application pages modified during the review process must be distributed in <br /> the same manner, along with proof of distribution. <br /> Please note that this form is only a listing of general category requirements and does not constitute a <br /> checklist of detailed permit application requirements. A finding of completeness should not be <br /> interpreted to imply adequacy of an application. Additional information not listed on this form may be <br /> required for adequacy depending upon the individual circumstances of an application. After a decision <br /> has been reached on this application, the operator must update the permit application on file at DRMS <br /> and OSM. <br /> This form consists of two major parts: (1) a section entitled "Application General Operation Information: <br /> and (2) a section entitled "Application Requirements." Specific instructions for filling in the necessary <br /> information for each section appears immediately below the title of each section. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly the appropriate information as listed below. Supplemental sheets may be used <br /> as necessary; such sheets must be attached to the form and referenced or keyed to the numbers on <br /> the form. <br /> 1. Application Number (to be filled in by the Division): C - - <br /> 2. Permittee: <br /> 3. Mine/Site Name: <br /> 4. Current Permit Type: C 0 <br />