PERMFILE59998

• Permit No: M1995010
• IBM Index Class Name: Permit File
• Doc Date: 2/6/1995
• Doc Name: LIMITED IMPACT OPERATION 110 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

~ • -2- •
PHRM.ITTING CONTACT' (if different from applicant/operator above)
Individual's Name: - Title:
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPHCTION CONTACT
' Individual's Name:
Compaq Name:
Street:
City:
State: ~ Zip Code:
Area Code: ~ Telephone:
CC: STATB OR FHDHRAL LANDOWNBR (if anv)
Agency: BIM
Street: 701 Camino Del Rio
City: ~~ o
State: Colorado Zip Code:
Area Code: 303 Telephone: [phone]
CC: STATE OR FHDHRAL LAN DOWNHR (if airy)
Agency:
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future (Poet-mining) land use (check one):
Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
X Ranyeland(RL) _ Foreatr]~(FR) Wildlife Habitat(WL)
-
_ Reaidential(RS) Recreation(RC)
industrial/CommerciallIC)
_ Developed Water Reaourcea(WR) _ Solid Waste Disposal(wD)
12. Primary ~res~ent land use (check one1:
Cropland(CR) _ Pastureland(PL) _ General Agriculture{GA)
~C Rangeland{RL) ForestrX(PR) wildlife Habitat(WL)
Residential(RS) - Recreation{RC) - IaduetrialJCommercial(IC)
_ Developed water Resourcea(WR) _ Miniag(2~IlY)
13. if this operation rill use designated chemicals, or rill result, or presently has
acid mine drainage - you canno use this application form. You must autmit a either
a 110d or 112d application form for Designated Mining Operations. 7n either case,
you must list any acidic or toxic-forming materials, exposed or disturbed as a
result of the mining operation, sad xhether the operation xill result in or
presently has acid mine drainage:
Descrintion of Conversion:
If you era converting as existing operation, provide a brief narrative describing the
proposed change (91_
Maos 6 Hxhibits:
Subsiit txo (2) ~
6.3.1 H77ffiiI83:T A
6.3.2 HSFiiBIT 8
6.3.3 H7QiIBIT C
6:3.4 HSHIBIT D
6.3.5 B7~iIBIT H
6.3.6 B~IIBIT F
:omplete, unbound copies of the following agplication exhibits:
- Legal Description and Location Map
- Site Description
- Mining Plan
- Reclamation Plan
_ Maps
- Liet.of Other Permits and Liceaaes Required