PERMFILE53689

• Permit No: M2002003
• IBM Index Class Name: Permit File
• Doc Date: 1/17/2002
• Doc Name: HARD ROCK/METAL MINES LIMITED IMPACT OPERATION 110 2 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

999
STATE OF COLORADO
DIVISION Of MINERALS AND GEOLOGY
Depanmenl of Natural Resources
1313 Sherman St., Room 27 5 J`yk~
Denver, Colorado 80203 ~~~~~,~~~ IIII
Phone: [phone]
FA%: (30 31 83 2-81 06 JpN 17 2002
DEPARTMENT OF
HARD ROCRfMETAL MSNES~fY!SIOIIi~M1R6fS(39SIdGC0I09M NATURAL
RESOURCES
LIMITED IMPACT OPERATION 110{2))
RECLAMATION PERMIT APPLICATION FORM
~ ~ Zt~c~2-OO~
Roy Romer
Governor
lames S. Lahhead
Executive Ovenor
M¢hael B. Long
Divmon Direnor
3ECR ONE: New Application (Rule 1.9) Conversion Application (Rule 1.11)
Permit # M- - - (provide for Conversions of existing permits)
>.e application for a Limited Impact (110(2)) Mining Operation Reclamation Permit contains three
Ljor parts: (1) the application form; (2) Exhibits A-J, Addendum 1, any sections of Exhibit S
id Geotechnical Stability Exhibit, as required by the Office, and outlined in Rules 6.1, 6.2,
.3, 6.4.19 and 6.5; and (3) the application fee. when you submit your application, be sure to
>clude one (1) signed and notarized Grev Original and one (1) copy of the application form, two
?) copies of Exhibits A-J, appropriate sections of 6..4.19 (Exhibit S), and 6.5 (Geotechnical
;ability Exhibit), as required, and a check for the application fee described under (4) below.
:hibits should NOT be bound or in 3-ring binders; maps should be folded to 8 1/2" X 11" or
1/2" X 14" size. To expedite processing, please provide the information in the format and order
escribed in this form.
GENERAL OPERATION INFORMATION
Type or print clearly, in the apace provided, all information described below.
Applicant/operator or comnanv name (name to be used on permit):

1.1 Type of organization (corporation, partnership, etc.
)
: p
Ql?. -~ on /~ t.f0
1.2 I.R.S. Tax ID No. or Social Security
N
umber: )
/
/
S
o
C 7 ~ //
`7' ~ ~ ~
7
~
~
~
Operation name (nit, mine or Bite name) lf~~b GC.~ 1/
n
ll'l~
- ~'V'/Y/ r
~
~
/// /~~lQ~
/`
Permitted acreage: 7 ~ ~ permitted acres
Fees
4.1 New Application 5875.00 application fee
4.2 Conversion Fee (from 110d to 110(2), Rule 1.11.2(2)) 5875.00 application fee
Prima rv commodities to be mined: ~

Name of owner of the subsurface rights of affected land:

Name
of owner of the surface of i
affected land:
~~~~~~~~r• F~

a. Na>~ of they holders of an y recorded easements on the affected land:
~e of ~ S ~ ace Underground In-situ