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.- ~ III IIIIIIIIIIIIIIII ~ ~~'~~~~~® <br />~ DEC 1 5 1992 <br />of cO~o <br />red -L'~~9Q D1V1;~101v OF <br />~, o DEPARTMENT OF NATURAL RESOURCES MINERgLg ~ GE <br />~ ~ a David H. Galcnea. Etecullve Director OL <br />°' MINED LAND RECLAMATION DIVISION <br />~ X876 ~ DAVID C. SHELTON, Director <br />Richard D. Lamm <br />Governor Application Form for a Permit <br />to - - <br />Conduct Coal Mining in Colorado - <br />Application to conduct surface or underground coal mining activities or other <br />surface coal mining and reclamation operations in Colorado pursuant to CRS, <br />34-33-101, et seg. <br />For an application to be deemed complete by the Division pursuant to CRS, <br />34-33-103(5) and Rule 1.04(30), an applicant must: (1)•supply all information <br />as specified on this application form; (2) submit five reproducible copies of <br />the permit application with original signatures; and (3) pay the appropriate <br />fee required by Rule 2.01.6. <br />Please note that this form is only a listing of general category requirements <br />and does not constitute a checklist of detailed permit application <br />requirements. A finding of completeness should not be interpreted to imply <br />adequacy of an application. Additional information not listed on this form <br />may be required for adequacy dependinG upon the individual circumstances of an <br />application. <br />This form consists of two major parts: (1) a section entitled General <br />Operation Information and (2) a section entitled Application Requirements. <br />Specs is instructions for filling in the necessary in of rmation ~r each <br />section appears immediately below the title of each section. ,~ ,~ - <br />GENERAL OPERATION INFORPIATION <br />Type or print clearly the appropriate information as listed below. <br />Supplemental sheets may be used as necessary, such sheets must be attached to <br />the form and referenced or keyed to the numbers on the form. <br />1. Application Number (to be filled in by the Division): C-~ ~ -~ $ <br />2. Perms ttee H A Y D E N G U L C H T E R M I N A L <br />- - - - - - - - - - - - - - - - - - - - - <br />s I N C._____ <br />3. )dine or Site Name: H A~~~~J_~ U L ~L-I ______ <br />L 0 .~ ~ .4 .mil ~ <br />4. Current Permit Type: C 0 <br />5. Application Submittal Date ~ ~/~ ~/S 2 <br />6. Application Fee: E1 ~ 1 ~ ~ Incremental Fee Schedule: <br />7. Commodity 14ined: C 0 A <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />