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~~. `"' ~ ~ <br />LIMITED IMPACT AND SPECIAL (TEN-DAY) <br />PERMIT APPLICATION FORM <br />STATE OF COLORADO ~ ~~ ~~~ <br />Mined Laad Reclamation Board <br />Department of Natural Resources <br />1313 Sherman Street, Room 723 f;iAR U- 19'18 <br />Deaver, Colorado 80203 <br />III IIIIIIIIIIilllll <br />Application for Mining <br />sad Reclamation Permit, <br />Pursuant to C.R.S. 1973, <br />34-32-101, et seq. <br />! N R-CLAf~ ' TIDN <br />LII3ITED IMPACT OPERATZ~~~'~L~o~~q~~e~SeSTTiAN ten acres (including all <br />roads, stockpile areas $d y o Pier sur ace facilities) over the life of <br />the mice, and must extract LESS THAN 70,000 tone of mineral, overburden <br />or combination thereof per calendar gear. If the affected area is some <br />faction greater than nine acres, be sure NOT to round it up to ten acres <br />sit the narratives or nlsevhere. <br />SPECIAL (TEN-DAY PROCESSING) operations must disturb LESS THAN tea <br />acres (including all roads, stockpile areas sad any other auaface <br />facilities), anr' can ONLY be obtained where a federal, state, county, <br />city, town, or special district centract calls far work to ba <br />commenced within a SPECIFICALLY SHORT TB~:. <br />TYPE OR PRINT CLEARLY 1"' 1 ~ ~. ~ D , 7 d - ~ v <br />1. Nana of operations Open pit - Girwi~l <br /> (Pit, mina, or site name) <br />2. Name of applicant/operator ~:~,~r~t~::.. <br /> (Name to be used on permit) <br />3. Addrasa sad phone number of <br />local offices t,--°-'~ '_...}° ~"'-` <br />.$O$21 Phone 7 3-2 <br />4. Address and phone number Same <br /> of general offices <br />5 Name sad phone number of person ir8.~ C;'w~. <br />. staff members should contact _2 <br />6. Owner(s) of record of affected James R P_i~_k_en „gh <br /> Iaad (surface area) <br /> (If more than 2, list below) <br />7 Owner(s) of substance to be mined Same <br />. (If more than 2, list below) <br />8. Source of legal right to enter Oral contract - See "G" <br /> (Indicate what type of proof is <br />included in Exhibit G - lease, deed, . <br /> notarized letter, etc.) <br /> tance to be mined <br />b <br />6 <br />i <br />f Open pit mine - :~ <br />9. su <br />s <br />m <br />ce <br />Type o <br />(Specify underground, strip, open pit, <br /> ate. and substance(s) to be mined) <br /> _ __......1 -.as.. c.,_ ..,_ <br />~ •t~f`11rT1 <br />:0. General locaeion 6 elevation ('isles <br />6 direction from nearest town 6 Elevation 5460' <br /> approximate site elevation) <br />;1. Coimtq ._ <br />L2. Acreage of affected lands Less than one acre <br /> (Total surface acreage to be <br />included is permit) <br /> <br />!3: <br />Application fee (See applicable Rule ~ /- <br />y~'`'«C/~L <br /> to determine amount) <br />