1995-05-03_PERMIT FILE - M1994117

• Permit No: M1994117
• IBM Index Class Name: Permit File
• Doc Date: 5/3/1995
• Doc Name: APPLICATION FORM
• Media Type: D
• Archive: No

lu Correspondence 1nt6Rna➢on:
APPLICANTIOPERATOR. ('name,address,and phone of name to be used on permit)
Contact's Name: Thames Heuer,Acting MITI Manarer Gwen Fraser, Preal
Company Name: C.O.M.Inc.
Street: PO Box 17364 3740 W.Margins{Was SW
City' Beddr _ 3"aw
State: CO 9030OA304 WA 90106
Phone [phone]
PERMITRNG CONTACT (if different from applicant/operator above)
Individual's Name:Thames Hal* Title: Arllaa MIN Mewwr
Company Name: C.O.M.Inc
Street, PO Bess 17304
City evidw
State. CO lip Code: 0030t1.0304
Aiea Code: 303 Telephone: [phone]
INSPECTION CONTACT
IrKlmdual'a Name Thwatee Harney Tide: Acting Mill Ma ger
Company Name: C.O.M.Inc.
S9met PO Box173"
City: no-Wow
Sure: CO Zip Code: t193MQJ"
.1rca Code: 303_ Telephone [phone]
CC: SIAILUKFbULRAL1.eWUVWNER(iiany)
Agency. buraau of LaaO MMMIR Mr
Street: ,77"l0.eJrt M1t>1�ytrrt _
City: CamonCRY
3WIc. t0 Zip Cudc. OIZ12
Area Code: Telephone:
CC STATE OR FEDERAL LANDOWNER(if any)
Agenoy
Street:
City
State. 71p Code!
Area Code. Telephone:
11 Primary future (Post•mwng) land use(check one).
Cropland(CR) -_Pastureland(PL) Ocneral Agriculture(GA)
_Rangeland(RL) _Forestry(FR) X Wildlife Habitat(WL)
_ Residential(RS) _Recreation(RC) _Industrial/Commercial(TC)
_Developed Water Resources(WR) _Solid Waste Disposal(WD)
12.Primary present land use (check one):
_Cropland(CR) Pastureland(PI.) _General Agriculture(GA)
Rangeland(RL) _Forestry(FR) Wildlife Habitat(WL)
_Residential(RS) _Recreation(RC) X IndusaWCommercial M)
Developed Water Resources(WR) —Mining(MN)
13 If this operation will use designated chemicals, or will result or presently has acid mine drainage . you cannot use this
application fotn You must submit either a I IOd or 112d application forth for Designated Mining Operations. In either
case, you must list any acidic or toxic•fonning materials, exposed or disturbed as a result of the mining operation, and
whether the operation will result in,or presently has acid mine drainage:
Description of CQPyersion.
If you are converting an existing operation,provide a brief narrative describing the proposed change(s).
2