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a <br />-, ROOF CO~O9 <br />9 <br />ye ~ o DEPARTMENT OF NATURAL RESOURCES <br />** X1\0+ * Dand H. Gelches, Ececutive Director <br />;,a,6. MINED LAND RECLAMATION DI\ <br />DAVID C. SHELTON, Director <br />Richard D. Lamm <br />Governor Application Form for a Permit <br />to <br />Conduct Coal t4ining 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 seq. <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 <br />and does not constitute a checklist of detailed <br />requirements. A finding of completeness should <br />adequacy of an application. Additional informs <br />• may be required for adequacy depending upon the <br />application. <br />general category requirements <br />permit application <br />not be interpreted to imply <br />ti on not listed on this form <br />individual circumstances of an <br />This form consists of two major parts: (1) a section entitled General <br />Operation Information and (2) a section entitled Application Requi ements. <br />Specs rc instructions for filling in the necessary in ormatron or eac <br />section appears immediately below the title of each section. <br />GENERAL OPEP.ATION INFORP!ATION <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 C Q~ Q R A D 0_ Y A M P A_ C O A L _ <br />C O M P A N Y <br />3. t4i ne or Site Name: C O L O R A D O Y A M P A C O A L <br />- - - - - - - - - - - - - - - - - - - <br />C O M P A N Y- <br />4. Current Permit Type: C 0 <br />5. Application Submittal Date 1 2 /1 7/ 8 6 <br />• 6. Application Fee: S_ p 5 0 0 Incremental Fee Schedule: <br />7. Commodity t4ined: C 0 A <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />