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. �ULAR (112) PERMIT APPLICATION <br /> FORM <br /> -3- <br /> NOTICE OF PROCEDURES <br /> After the application is considered "filed" (pursuant to RULE 1 .1(10)) with the Mined Land <br /> Reclamation Division, notice procedures outlined in RULE 2.2 must be followed. (Format for <br /> such notices will be included in the letter you receive from the MLR Staff informing you of <br /> the completeness ("filing") of your application. <br /> COLORADO WATER LAWS <br /> The permittee is encouraged to contact the State Engineer, with regard to the administration <br /> of water rights, and the Colorado Department of Health, with regard to the discharge of <br /> pollutants into the waters of the state. Violation of Colorado water laws could result in <br /> enforcement actions taken by the State Engineer and/or- the Colorado Department of Health. <br /> ADDITIONAL INFORMATION <br /> This space can be referenced for further information of any of the items in this form. <br /> To the best of my knowledge, all the information presented in this application is true and <br /> correct. <br /> BY: J �� ,�f� <br /> TITLE: y 'f"„ "" G-5 <br /> (Signature by individual legally authorized to <br /> bind the operator to this application) <br /> DATE: 3 Z9 f 3 <br /> j (Rev. 7-29-B2) <br />