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O.C. !l2 CoN Mins -Permit No. C-80-002 <br />~ Prior Experiencrr <br />~r <br />project Name (.[/n}fE~J_ t <br />Project Owner I.DTEAtI.. <br />Contact Name ~JDE F <br />Brief bescription of Project lin <br />lo'I'. <br />6r <br />FROn1 <br />Project Name 1 - PJgLY^ <br />Project Owner ~i~ pF ukFl~( <br />Contact Name TSa~oA E ~ i <br />Brief Description of Project (include location an`~size) <br />850 Acli= G'ot-L p NE N~7}l~ <br />Rs ~ .5uac+~Nru~ ctoR ~n S. F. S <br />1940 -19902,, n <br />,~e '101 R73 -~,2g~ <br />SFi./NE A4779 FOR 6LUF <br />77y,F 4JACLD, / l~Nl) 14 <br />NVr2ONMJ~~ ~~~~,~ {c,~:l <br />flerpec~ 198 7 <br />~u~ <br />R,<O QAk, DK~R+~cwtA , <br />+ {IcSOC, p~ DENvEl2 ~ <br />~ Tf1E" FJt-T/rQE Mrwnl6. <br /> <br />The undersigned agrees to comply with all Rules and Regulations of the Colorado Surface Coal Mining <br />Reclamation Act, the General Conditions of the Purchase Order and the' Purchase Order Terms and <br />Conditions and all other requirements of these documents: <br />Individual or Company Name <br />Professional Cert'rfication No, <br />Phone <br />r <br />d location and size) <br />F rATS~APtdti <br />RECEIVED <br />AUG 3 D 1995 <br />Division of Minerals & Geology <br />r.q. t or t r.o. <br />