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7i7a <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) <br />~~ <br />`I <br />,I <br />'LCti <br />~+ <br />