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1 <br />_I. ~ ~~,~ Pte. <br />~~ pf C0 <br />~e <br />.^ • <br />.`• <br />,, 7~ • <br />RIC~~N D. l~nMn <br />Oogrnor <br />DEPARTMENT OF NATURAL RESOURCES <br />D~r10 H. UtlcMr. Ex~cullw DM~clor <br />MINED LAND RECLAMATION DIVISION <br />DAVID C. eM[LTDM, Wreobr <br />A <br />NOTICE OF INTENT TO EXPLORE INVOLVING REMOVAL OF 250 TONS OR LESS OF COAL <br />Dermit Submittal Information: <br />Notice of Intent No. <br />Prospector: <br />Project Name: I _ k~~0.~e~ '~ ~ <br />Date: 3 ' ~~o' ~ ~ Application Fee: <br />Incremental Fee Schedule: No <br />Mineral Ownership: Federal State <br />Surface Ownership: Federal State <br />Mine Type: 0 R <br />Current Dernlt Status: A P <br />County: La17~~~ -- <br />Commodity Mined or Explored: ~4 <br />Private !~ <br />Private ~ <br />NOTE: Exploration must be conducted in compliance with the Rules and <br />lreg-ulatlons of the Colorado Mined Land Reclamation Board for Coel Mining, <br />adopted in accordance with the Colorado Surface Coal Mining Reclamation Act, <br />CRS 34-33-101 et se This form must De fi11Rd out entirely before it can be <br />considered compTe~ Three copies of this Notice, including maps and <br />additional attacMMpts, s'Tiould be subatitted to the Division of Mined Land <br />Reclamation. Dleelte refer to Rules 2.02, 3.05, 4.07, 4.21 and 5.01 for <br />specific regulatory requirements. <br /> <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866.3567 <br />_ ......_ _.,.. ~._...~ .. ... r <br />