PERMFILE54436

• Permit No: M1994117
• IBM Index Class Name: Permit File
• Doc Name: APPLICATION FOR A MILLING AND RECLAMATION PERMIT GOLD HILL MILL LIMITED IMPACT PERMIT
• Media Type: D
• Archive: No

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•LIMITHD IMPACT OPBRATION (110)
RBCLAMATION PHRMZT OEC ~ 2 1994
APPLICATION FORM
CHHCR ONH: i New Application (Rule 1.4) Conversi ~~ADnliC3L~}pr~;~9e~1.11)
Permit # M~-~~_ (provide for conversioSSn~i~Osf~T00oIlfllVV~imm~ee~gd~l®SStdi~g ps~nits)
The application fora Limited Impact Designated Mining Operation Reclamation Permit contains
three major parts: (1) the application form; (2) Hxhibite A-J, ~n required sections of
Bxhibit S and Geotechnical Stability Hxhibit, as required by the C1~~~iN~';"~'S}A+~ ahte~~pd in
Rules 6.1, 6.2, 6.3, 6.4.19 and 6.5; and (3) the application fee. When you submit your
application, be sure to include one (1) sicned and notarized original and one (1) copy of the
application form, two (2) copies of Hxhibits A-J, appropriate sections of 6.4.19 Bxhibit S
and 6.5 (Geotechnical Stability Hxhibit), as required, and a check for the application fee
described under (4) below. Hxhibits should not be bound or in a 3-ring binder; maps should
be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the
information in the format and order described in this form.
GSNBRAL OPBRATION INFORMATION
Type or print clearly, in the space provided, all information described below.--~G~~///~(/
1. Applicant/operator or company name (name to be used on permit):
n n •~ r„n ~Q~~"169
1.1 -aype of organization (Corporation, partnership, etc.): ClOAL^iR a ~/DA/
1.2 I.R.S. Tax ID No. or SOCial Security Number,:' ~~-(d.l=fs"~t
2. Operation name (pit, mine or Bite name) : (oL,A /SILL HILL
3. Permitted acreage (new or existing site): permitted acres
3.1 Change in acreage (+ or -) acres
4. Fees:
4.1 New Application ~ 5875.00 application fee
4.2 Conversion Fee (f ram 110d to 110 S75 00 conversion fee (Rule 1.11.2(2))
i s. Primary commoditie(s) to be mined: G oLD s/LVFJ1
6. Name of owner to the subsurface rights of affected land: ~~A/C.
7. Name of owner to the surface of affected land: LI.D,M . Sn/C.
8. Type of mining operation: _ Surface _ Dnderground /In-situ MlL(.~NG
9. Location information. The n r of the area where the majority of mining will
occur lies in:
couNT~r: Boulder
PRINCIPAL MHRIDIAN (check one): / 6th (Colorado) _ 10th (New Mexico) _ IIte
SHCTION (write number): g 1a~
TOWNSHIP (write number and check direction): T ~ i/North South
RANGB (write number and check direction): R /~L _ 8aet ~ west
QDARTSR SBCTION (check one): / NH NW _ SH _ SW
QIIARTBR/QIIARTHR SHCTION (check one): lI N8 _ NW _ SB _ SW
GBNHRAL DBSCRIPTION: (miles and direction from nearest town and approximate
elevation) jr'1ri6 f'6Er. ,Lo ~~~_~Rly! eaudn~.c
10. Correspondence Information:
APPLICANT/OPHRATOR (name, address, and phone of same to be used on permit)
Contact's Name: J.~JHYNe7T7rM~ GFN_(jYQT~uIEAl C~C A Title: P~.GJl1164(T
company Name: ~,D.K,yI'Vc.
Street: ylW`sµ,/~{(ivE qd a9~o i.), r1~/j~(,IJ(j9y~J~ f tel.
City: ~p(i,LDF.7 SEA7Tli/
State: l~Q C D.t.. Zip Code: p~,~
Area Code: (~oiL Telephone:
y~9-744b