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_ ~ ~ 111111 1111111 111111 <br />9 TSTE O~ COIORSOO ~iC w+A^ 7. '_aw. ,nva•~n. <br />DEPAR+NENT OF NOTURLI RESOURCES <br />0. Mena bees.. E+autive DineMr <br />rIL\ED L~\D RECL~~I~TIO <br />X23 Centennial Builtling, 13135herman Slraet <br />Oenrer, Coioratlo 80203 Tat. (303) 8343587 <br />DATE: <br />VAME OF <br />FILE VO <br />David C. Shelton <br />/9~) Y Diroctor <br />APPLICANT: G..La.~2 ~af;~c~-C.oa~C~~ ~.°,.:~± - )~-n~~~~~a%1~n.~~ <br />/~ _ <br />.. ~_~~°a6> ~G <br />7 > , <. <br />J <br />This work sheet is used for the completeness review conducted pur- <br />suant to the Colorado Surface Coal Mining 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 }lining 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 what is necessary to correct it. <br />I*lFORMATIOV C.aTEGORY CO~LNEVT <br />1 ~ Vame of Operation ~~- <br /> ~' Vame of Applicant /l <br />la I~ Address and Phone of Local Office ~ <br />~ ri <br />2b ~ Address and Phone of General Office ~ ri <br />3 _ Contact Person ,~ <br />4 ~ Parent Corporation ,~ <br />5 rl Vame, address and Phone of Operator ( ~ <br />6 ~ Vame and Phone of Resident Agent ~ <br />7 = Current and Previous Permits ~ <br />8 _ Type of Nine ', ~) <br />9 ~ Surface Land Ownership 11 <br />10 ~ Mineral Ownership (( <br />11 C General Location and Elevation ;i <br />1? ;--~ County ~l <br />13 ~ Public Office/Public Inspection Copy <br />tt <br />