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<br />' ~IMITED IMPACT (110) and
<br />'• SPECIAL TEN-DAY (111) PERMIT
<br />APPLICATION FORM
<br />State of Colorado
<br />Department of Natural Resources
<br />MINED LAND RECLAMATION BOARD
<br />1313 Sherman Street, Room 723
<br />Denver, CO 80203 (303) 839-3567
<br />
<br />E~ ECEIVED-i-~ -Appl icatlon for Mining and J
<br />-•~.,;• Reclamation Permit, pursuant
<br />--DEC 2 1 1978 .. ~ _"to CRS 1973, 34-32-101, et seq
<br />TION SECTION - : • - ... ~O . -(
<br />0010. wept. OT IYBID faI neaum cea
<br />The following explanations cover Limited Impact appiicetions~•(110s) and Special (Ten-
<br />Day Processing)(Ills) applications. In the interests of efficient processing, please
<br />check the appropriate box to indicate which type of application you are applying for here.
<br />LIMITED IMPACT OPERATIONS must disturb LESS THAN 'ten acres (including ,
<br />all roads, stockpile areas and 'any other surface facilities) over the
<br />life of the mine, and must extract LESS, THAN 70,000 tons of mineral,
<br />overburden or combination thereof per calendar year. If the affected
<br />area is some fraction greater than nine acres, be sure NOT to round this -
<br />figure out to ten acres in the narratives or elsewhere.
<br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN ten acres
<br />(including all roads, stockpile areas and any other surface facilities),
<br />and can ONLY be obtained where a federal, state, county, city, town or
<br />special district contract calls for work to be commenced within a
<br />SPECIFICALLY SHORT"TIME.
<br />(Type or Print Clearly)
<br />1. Name of operation , A ~ E2'
<br /> (Pit, mine or site name)
<br />Lo/2A 8oB65~-
<br />2. Name of applicant/operator ~, ~f //^/T-
<br /> (Name to be used on permit)
<br />3. Address and phone number of ~~r7 ~!r /~ 1/ C~ ~~~ 150~/^/~
<br /> local offices
<br />4'I/-.~'~ 4 X90
<br />4. Address and phone number of ~~ F ( FR /T~ C `~ LIJ. l~l~~?/ ~ S, [1
<br /> general offices __.
<br /> ~- ~~ a
<br />.
<br />5. Name and phone number of person _
<br />AX ~ • ~/1 / ~1 ~~~///
<br /> staff members should contact
<br /> ~/ - . ~~~
<br />6. Owner(s) of record of affected
<br />g
<br /> land (surface area) (If more F
<br />F.F. ~ /F /T
<br /> than 2, list below)
<br />7. Owner(s) of substance to be mined 57 ~ X %//f3 / %
<br /> (If more than 2, list below)
<br />8. Source of legal right to enter
<br /> (Indicate what type of proof is S~,c ,,C~(~// ~ T
<br /> included in EXHIBIT G - lease,
<br /> deed, notarized letter, etc.) ""' ,"-
<br />9. Type of mine E substance to be
<br />mined (Specify underground, strip, "~. . - _
<br />P,FiV 1~/ r ~ ,/ r r R_ C~'r7A ,l
<br /> open pit, etc. b substance(s) to ~
<br /> be mined)
<br />10. General location b elevation
<br />(Miles b direction from nearest ""~ - ` •~ ~• ..+c+r ,:~•
<br />RF ~.~~f~~.~ ~
<br /> town b approximate site eleva-
<br />
<br />t i on) -
<br />_ _
<br />~^ ~~C~/~/r-C
<br />~LUN l/
<br />ll. County .__..~_.._._._. _ ~_~_~ ..,R~:_
<br />12. Acreage of affected lands jy/S /~1/OL/LD^~.EP~ND ON AG~TS
<br /> (Total surface acreage to be _ ,_, _ _
<br />~
<br /> included in ermit ~
<br />/-t /J
<br />3, pp cation ee (See applicable __
<br /> RULE to determine amount) / / ,/- / yF Tn / T F, /1//~/ i
<br />i_.: _. ..,..,.. .. _.
<br />
<br />(over)
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