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. ..c -• -• <br />application Form fora 2ermit <br />to <br />Conduct Coal Nixing in Colorado <br />State of Colorado <br />Department of Vatural Resources <br />:117lED LLYD RECI~MA2ICN DIYISICPf <br />1317 Sher~aan Street, Rocm 413 <br />Denver, Colorado 40103 (303)839-3507 <br />*This is a permit submission under State Rule <br />* .7DOliC3LiOn to conduct sur_'ace <br />or undery:ound coal :vining <br />activities or tract surface coal <br />mining and recla:aation ocetacions <br />in Colorado oursuanc to C?S 1973, <br />3C-33-171, et. sea. <br />2.01.3(5) <br />For an application to be deemed complete by the Division pursuant to ~.?S 1973, <br />3C-33-.03 (5) and~Rule i. 04 (30), an applicant must: (I) supply a_'l inioraa ci on as <br />specified on this application form; (1) submit five reprcducible conies of t.= permit <br />application with original signatures; and (3) lay tae acpropriace fee rewired by <br />Rule 2.Ol.o. <br />?lease note t.`at this form is only a listing of general category re;uirements and <br />does not constitute a checklist of detailed permit application recvirements. .~ <br />finding of completeness should not be interpreted to imply adequacy cf an appli- <br />cation. add ticnal information not listed on this _°ora .:ay :^e re;u`ted `cr ade^vac~ <br />depending upon the individual c_'rcm:stances of an application. <br />:his form consists of two ma,'or parts: (_') a section en ti tied ;eneral Cceration <br />Ii ornation and (Z) a section entitled ,toolication .~eguiremenLS. Specific .nsLruc- <br />tions for filling i-t the necessary i:_'or:nacion fcr each section appears ^vteriatel3 <br />~e1ow tae t_tle of each section. <br />~~c:lcR:.L 0?~ W.T_TO.Y _^.iFCR.N:,TIDi7 <br />^ype or print clearly the approcriate inic ^aaticn as __sted te_o:+. Sup:'=nentai <br />s::eets ,nay be used as necessary, s;:ca sheets must be attacaed to tae _'crm and r_- <br />. _r^rced or .ieyed Lo tae numcers on tae _'orm. <br />_. :rave of oceracion Colorado Ya:rq~a Coa'_ CoRq~any, P~Lines <br /> ?it, nine or site vane) 1, 2 and Eckman Park <br />.. :lame cf ~policant I Colorado Yampa Coal Carq~any <br /> (tame to :;e used an oer-it - ~ <br /> tae petmi.ttee) <br /> ~ P.O. Dox 772129 <br />:a. address and phone nurwer o° I Steaia~>a3t Springs, Colorado 80477 <br /> local offices i 0031 R70-"i~tnn <br />3b. Address and phone number or ~ <br /> jen era- O~_°1CB5. <br /> $7PY? <br /> S. tdatson, Manager oL Engineering <br />3. :Iar..e and phcne number of ;erson and P. Larry 0..maru, Permit Coordinator <br /> sta:f memaers should contact (303) 879-3800 <br /> I Cctty Oil Company <br />C. ?arent Corpora tics, .f any I Coal Department, Minerals Division <br /> (:neluda name and address) ~ 5250 South 300 West, Suite 200 <br /> I Post Office ISax 7900 <br />i <br /> Salt Lake Ci[y, Utah 84107 <br />