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<br /> • <br />STATE OF COLORADO qiC HAgD D M. Dovc,nm <br />. <br />DEPARTMENT OF NATURAL RESOURCES <br />D. Monte Pescos, E>tecutive Director <br />iii iiiiiiiiiiiiiiii <br />MINED LAND RECLAMATION <br />423 Centennial Building, 1313 Sharman Street <br />°DenGer.'Cblorado 80203 Tel. (303) 839-3567 <br />DATE: I p <br />NAME OF APPLI/CANT /S,u.~..( <br />FILE NO.: (,COI/ S/~- <br />~l:Z <br />This work sheet is used for the completeness review conducted pur- <br />suant to the Colorado Surface Coal Dtining Reclamation Act, C.R.S. <br />34-33-101 et seq. <br />Directions: The information categories listed below correspond to <br />the information categories listed in the Application for a Permit '' -~ <br />to Conduct Coal Mining in Colorado. If a box is checked, then the <br />operator has met the requirement for Completeness for that category.. <br />If a box is not checked, then the operator has not met the require- <br />ment for Completeness for that category. The comment column will <br />identify the defieiency and lahat is necessary to correct it. <br />INFORh1ATI0N CATEGORY CO'~tt•4ENT <br />1 ~{~f Name of Operation <br />2 Name of Applicant <br />la Address and Phone of Local Office <br />lb Address and Phone of General Office <br />3 ,rY Contact Person <br />4 Parent Corporation <br />S Name, Address and Phone of Operator <br />6 Name and Phone of Resident Agent <br />7 Current and Previous Permits <br />8 ~ Type of Mine <br />9 Surface Land Ownership <br />10 Mineral Ownership <br />11 General Location and Elevation <br />12 County <br />13 Public Office/Public Inspection Copy <br />David C. Shelton <br />Director <br /> <br />