Laserfiche WebLink
v �� ii c.. ti...��, \..�....JLti,,.Jt 1t 1LJ'\..J <br /> U!Yl510N Qf RECtAAAATlON,MIi+I1NG AND SAFEIY <br /> Department of Naturai Resources <br /> 1313 Sherman St.,Roam 215 <br /> Denver,Colorado 80203 C Q L O R A D Cl <br /> Phone:(3fl3}86(r3567 D !Y 1 5!O N o � <br /> RECLAMATION <br /> FAX:(303)83T�8106 M I N I N G <br /> ._._.,�._._ <br /> LL'VtTTED�'IPACT OPERATIUr(110(2)) ��ETY <br /> RECLAMATION PERMIT R���� <br /> �,�.,,;,� - ' � APPLICATION FORM <br /> APR 15 2022 <br /> DIVISION OF RECLAMATION <br /> CHECK ONE: NewApplicatian{Rule 1.4} �Conversion Applicatian(Rule I.11) MINING AND SAFETY <br /> Permit#M�?? �,J(�rovide for conversions of existing Permfts) <br /> The spplication for a Lunited Impact Deszgnated Mining Qperarion Rextamation Pernut contains tlu�ee rnaaor parts: (1} the applicafiion <br /> form; {2)E2chibits A-J, any required�tions of Exhibit S and Geot�hnicat Stability E�chihit,as required by the Office,azcd outlin€d in <br /> Rules 6.1,6.2,b.3,6.4.19 az►d 6.5;and(3)the application fe�. When you submit your apglication,be sure ta include one(1)si�ned and <br /> notaxized or'rginal and one{1}copy af the application form.two�(2)cc�pies of Exhibits A-J,appropriate sections of�i.4.1 R Er.t�bit S and 6.5 <br /> (Geotechuical Stability Exhibit),as requirecl,and a check for the application fee described under{4)below.Exhibits should not be bound <br /> or ia a 3-ring binder;maps should be folded to 8 1!2"X 11"or 8 1/2"}C 14"size. To expedite processing,please pxovide the ic�formatian <br /> in the format and order described in ttus form. <br /> GFNERAL OPERATTO:�L'�FORMATIO'� <br /> Type or print clearly,in the space provided,a8 information described below <br /> 1. ARpticanUoperator or corauanv uaxne tname to be ased on the uermit)• <br /> 1.1 Type of organization(catporation,parfiership,etc.): a i V�,Gt,l9� <br /> 2. Operation name(nit�mine or site namel. _YOf O �,�c� /�i4NCl1 �lif CP_.(' /�i,V� <br /> 3. Permitted acrea e ne or eush'ng site : ��_permitted acr�s <br /> Q. Fees: <br /> 4.1 New Application Slt4}4�5.00 agpiication fee <br /> 4.2 Amendrneni Application(frorn 1.i 0(2}) <br /> 4.3 Conversion Fee(from I lOd to 214{2},(Ruie l.l I.2(Z)) �1.'T�S.00 conversion fee <br /> 5. Primary commoditie(sl to be mined: _�D�R C�' 4 0�U� <br /> � <br /> 6. Ysme of owner to the surface of affected land: 7a�n/ �.CA�4mil/2 <br /> � <br /> 7. Name of owner to the subsurface riQhts of affected land; __JG�u✓ �70�e.. <br /> 8. T�ae of rninins oaeration: � Surface � Underground � In-situ <br /> OEfice of 4ffice of <br /> Mir�ed tand R�farrration Denver • Grand Junct#an • DuranSa � ;4div�and}nacfive lNines <br />